C 4411(1) WANSLAD 1 A O.hazan s.53 2Lybrary Wood kory borough of wan 20 wanstead and woodford Annual Report of the MEDICAL OFFICER OF HEALTH For the Year Ending 31st December, 1955 67? F<3 PUBLIC HEALTH COMMITTEE Councillor R. A. Dalton (Chairman) Councillor S. J. Relph (Vice-Chairman) Alderman R. W. Dale Alderman H. Hann Alderman Mrs. E. F. M. Hollis Alderman V. E. Stevens Councillor Mrs. S. V. F. Ashton Councillor F. B. Baverstock Councillor N. E. Britton Councillor R. W. Brown STAFF OF PUBLIC HEALTH DEPARTMENT Medical Officer of Health: F. G. BROWN, T.D., M.B., B.Ch., D.P.H. Chief Sanitary Inspector: M. G. Crook, M.S.I.A. (a) (b) (c) (d) (g) Deputy Chief Sanitary Inspector: J. T. S. Templeman, M.S.I.A. (a) (b) (i) Sanitary Inspectors'. A. J. Storer, M.S.I.A. (a) G. F. Downing, M.R.San.I., M.S.I.A. (a) (b) (d) (f) (h) (Resigned 19.6.55) D. R. Chanin, M.S.I.A. (a) E. W. Patrick, M.R.S.H. (a) (b) (e) (i) (Commenced 11.7.55) Clerks: A. M. Rowlatt (Resigned 5.11.55) R. M. Jamieson (Commenced 5.12.55) Mrs. V. Birkett (a) Royal Sanitary Institute and Sanitary Inspector's Examination Joint Board Certificate. (b) Royal Sanitary Institute Certificate of Meat and other Foods. (c) First Class Certificate in Laboratory Technique of Meat Inspection of Smithfield Technical Institute. (d) Diploma of the Royal Institute of Public Health and Hygiene. (e) Royal Sanitary Institute's Smoke Inspectors' Certificate. (f) Diploma in Sanitary Science as applied to Buildings and Public Works. (g) General Instructors (Special) Certificate, Home Office Civil Defence School, Falfield, Glos. (h) Associate Member, Institute of Sanitary Engineers. (i) City and Guilds Boiler House Practice Certificate. 2 Wanstead and Woodford Borough Council To THE MAYOR, ALDERMEN AND COUNCILLORS, BOROUGH OF WANSTEAD AND WOODFORD Mr. Mayor, Ladies and Gentlemen, I have the honour to submit my Annual Report on the Health Services in the Borough for the year 1955. As previously, a section of the report is devoted to those personal health services under the National Health Service Act which are administered by the Essex County Council. A brief outline of the School Health Service is given. Vital Statistics The total number of live births for the year was 694, 9 fewer than in the previous year. The Birth Rate per 1,000 of the population was 11.4, a figure almost identical with that of 1954. The figure for England and Wales as a whole is 15.3. The total number of deaths was 649, an increase of 39 over the figure for the previous year. Death Rate per 1,000 is 9.7 comparing with 11.7 for England and Wales. Although slightly higher than last year the Infant Mortality Rate (number of deaths under 1 year per 1,000 live births) reached the comparatively low figure of 17.3 contrasting with a figure of 24.9 for the whole country. Causes of Death As formerly the main causes of death were diseases of the heart and arteries, and cancer. However, as will be seen in the table under Section A of the report, the deaths from cancer fell from 135 to 119, this figure being the lowest recorded during the past 6 years. Infectious Disease By far the largest notifications were in respect of measles, 938 cases being recorded. Almost all were extremely mild. The incidence of whooping cough was small. 3 There were 12 cases of poliomyelitis, this being double the number notified in 1954. Six of the twelve cases were non-paralytic. Attention was first focussed on the disease towards the end of July when a boy attending a day school in the Borough, but living outside, developed a severe form of paralytic poliomyelitis. A number of contacts, some of whom were unwell, were kept under close observation. Activities of children attending the school were restricted and some scouts who were about to go to Switzerland had their trip postponed. Naturally many parents became very anxious and the Health Department received many queries. Fortunately no spread of the disease from this source occurred. The cases notified in the Borough were widely scattered and, apart from 2 infant children living under very poor circumstances in the Aldersbrook Camp, no direct contact was established. The incidence gradually abated, the last paralytic case being notified in early September. Five of the six paralytic cases recovered completely with no residual handicap. During September an outbreak of paratyphoid fever occurred in a Metropolitan Borough. An employee at a bakery there who lived in Woodford, was found to be a symptomless carrier of the disease. The matter was reported to the Public Health Committee who agreed to compensate the man during the period in which he was forbidden to work. However, after 2 weeks, he obtained other employment which was not concerned with the preparation or handling of food. Health Education On page 24 the Chief Sanitary Inspector has given an account of the Health Exhibition which was held in April in the Sir James Hawkey Hall. This was the first occasion on which an exhibition of this size, comprising various aspects of Public Health, was staged in the Borough. I was impressed by the large attendances during the 3 days on which the exhibition took place and by the interest which was shown by the public. At the conclusion of the exhibition one felt that the time and labour which were expended had been well worth while. At its December meeting the Public Health Committee agreed to the holding of a 2-day practical course for Health Visitors and Sanitary Inspectors on "Visual Aids and their construction, public speaking and group leadership." The course was sponsored by the Central Council of Health Education who provided the material and the lecturer. Sanitary Inspectors from neighbouring authorities were invited to attend and the result was most successful. My thanks are due to the Staff of the Public Health Department for their co-operation throughout the year. 4 Appreciation is given to the Chairman and Members of the Public Health Committee for their continued support and for the very great interest they have shown in the work of the Department. I have the honour to be, Mr. Mayor, Ladies and Gentlemen, Your obedient servant. F. G. BROWN, T.D., M.B., B.Ch., D.P.H. 29th August, 1956. 5 SECTION A STATISTICS AND SOCIAL CONDITIONS OF THE AREA Area (in acres) 3,824 Population—Registrar-General's estimate mid-year 1955 61,380 Registrar-General's estimate mid-year 1954 61,550 Rateable Value £542,000 Sum represented by penny rate £2,593 Extracts from Vital Statistics of the Year LIVE BIRTHS Legitimate Males 343 Females 326 Total 669 Illegitimate Males 10 Females 15 Total 25 Total Males 353 Females 341 Total 694 Birth-rate per 1,000 of the estimated resident population— 11.4 STILLBIRTHS Legitimate Males 8 Females 2 Total 10 Illegitimate Males — Females 1 Total 1 Total Males 8 Females 3 Total 11 Rate per 1,000 total (live and still) births— 15.6 DEATHS Males 308 Females 341 Total 649 Death-rate per 1,000 of the estimated resident population— 9.7 Deaths from puerperal causes:— Puerperal and post-abortion sepsis — Other maternal causes 1 Total 1 Rate per 1,000 total (live and still) births— 1.42 Deaths of infants under one year of age:— All infants per 1,000 live births 17.3 Legitimate infants per 1,000 legitimate live births 16.3 Illegitimate infants per 1,000 illegitimate live births 40.0 1955 1954 Deaths from Cancer 119 135 „ „ Measles Nil Nil „ „ Whooping Cough Nil Nil „ „ Diarrhoea (under 2 years of age) Nil Nil „ „ Road Traffic Accidents 7 1 „ „ Suicide 6 9 Other violent causes 6 7 6 Population. The Registrar General's estimate of the population for 1955 (midyear) was 61,380, a decrease of 170 on the figure for 1954 (mid-year). Extracts from vital statistics of the year Statistical tables have been included in this Report to show the health of the community in the Borough over the past twenty years. 7 Birth-rates, Death-rates, Analysis of Mortality, Maternal Mortality, and Case-rates for certain Infectious Diseases in the year 1955. England and Wales, London, 160 Great Towns and 160 Smaller Towns (Provisional Figures based on Quarterly Returns). England and Wales 160 County Boroughs and Great Towns including London 160 Smaller Towns (Resident populations 25.000 to 50.000 at 1951 Census) London Administrative County Borough of WANSTEAD and WOODFORD Births: (Rates per 1,000 Home Population) Live 15.00 14.90 14.90 15.10 11.40 Still 0.35 * * * 0.18 Deaths: All Causes 11.70 11.60 11.60 11.50 9.70 Malignant Neoplasm Lung and Bronchus 0.39 0.45 0.37 0.57 0.39 Whooping Cough 0.00 0.00 0.00 0.00 — Diphtheria 0.00 0.00 0.00 0.00 — Tuberculosis 0.15 0.17 0.13 0.17 0.06 Influenza 0.07 0.06 0.07 0.05 0.10 Coronary Disease —Angina 1.59 1.60 1.60 1.57 1.24 Acute Poliomyelitis & Polioencephalitis 0.01 0.01 0.00 0.01 — Pneumonia 0.49 0.53 0.45 .48 (Rates per 1,000 Live Births) All causes under 1 year of age 24.90 25.10 25.20 23.20 17.30 Enteritis and Diarrhoea under 2 years 0.75 * * * - *Figures not available. 8 Notifications: England & Wales Borough of Wanstead & Woodford Typhoid Fever 0.00 — Paratyphoid Fever 0.02 — Meningococcal Infection 0.02 — Scarlet Fever .733 0.28 Whooping Cough 1.78 0.33 Diphtheria — — Erysipelas 0.01 0.06 Smallpox — — Measles 1.58 15.18 Pneumonia 0.67 0.21 Acute Poliomyelitis (including Polioencephalitis): Paralytic 0.08 0.08 Non-Paralytic 0.06 0.11 Food Poisoning 0.28 0.47 Rates per 1,000 Total Births (Live and Still) Puerperal Fever & Pyrexia 17.77 59.57 9 Maternal Mortality Abortion Other Total England and Wales 0.12 0.52 0.64 Wanstead and Woodford — 1.42 1.42 Causes of Death as given by the Registrar-General, 1955: Causes of Death Males Females Total 1. Tuberculosis (Respiratory) 2 1 3 2. Other forms of Tuberculosis — 1 1 3. Syphilitic Disease 2 1 3 4. Diphtheria — — 5. Whooping Cough — — — 6. Meningococcal Infections — — — 7. Acute Poliomyelitis — — — 8. Measles — — — 9. Other Infective and Parasitic Diseases — — — 10. Malignant Neoplasm—Stomach 9 4 13 11. Malignant Neoplasm—Lung and Bronchus 21 3 24 12. Malignant Neoplasm—Breast 1 13 14 13. Malignant Neoplasm—Uterus — 1 1 14. Malignant Neoplasm—Others 31 36 67 15. Leukaemia 4 — 4 16. Diabetes 2 4 6 17. Vascular Lesions—Nervous System 31 67 98 18. Coronary Disease, Angina 53 33 86 19. Hypertension with Heart Disease 10 8 18 20. Other Heart Disease 27 72 99 21. Other Circulatory Disease 16 21 37 22. Influenza 3 3 6 23. Pneumonia 11 19 30 24. Bronchitis 30 9 39 25. Other Respiratory Diseases 2 1 3 26. Ulcer of Stomach or Duodenum 6 3 9 27. Gastritis, Enteritis and Diarrhoea 4 1 5 28. Nephritis and Nephrosis 3 2 5 29. Hyperplasia of Prostate 4 — 4 30. Pregnancy, Childbirth, Abortion — 1 1 31. Congenital Malformations 4 3 7 32. Other Diseases 21 26 47 33. Motor Vehicle Accidents 5 2 7 34. All Other Accidents 2 4 6 35. Suicide 4 2 6 36. Homicide and Operations of War — — - Totals, 1955 308 341 649 Totals, 1954 305 305 610 10 Infant Deaths, Neo-Natal Mortality and Stillbirths Stillbirths Neo-Natal Deaths Infant Deaths Year Live Births Birth Rate No. Per 1,000 Live Births Per 1,000 Population No. Per 1,000 Live Births No. Per 1,000 Live Births 1955 694 11.4 11 15.8 0.18 9 12.9 12 17.3 1954 703 11.3 15 21.3 0.24 7 9.9 10 14.2 1953 791 12.9 11 13.9 0.18 12 15.2 20 25.2 1952 751 12.1 10 13.3 0.16 15 20.0 17 22.6 1951 768 12.4 21 27.3 0.34 6 7.8 11 14.2 Maternal Mortality The maternal mortality rates (per 1,000 total births) for the past five years have been as follows:— Deaths Rates per 1,000 Births (Live and Still) Year Total Births Registered Puerperal Sepsis Other Maternal Causes Total Puerperal Sepsis Other Maternal Causes Total 1955 705 - 1 1 - 1.42 1.42 1954 718 - 1 1 - 1.39 1.39 1953 802 - - - - - - 1952 761 - 1 1 - 1.31 1.31 1951 789 1 1 2 1.27 1.27 2.54 Maternal Mortality, Stillbirths and Neo-Natal Deaths Rate per 1,000 Live Births 1955 1954 1953 1952 1951 Maternal Mortality 1.44 1.42 — 1.33 2.60 Stillbirths 15.80 21.3 13.9 13.3 27.3 Neo-Natal Mortality 12.90 9.9 15.2 20.0 7.8 During 1955 there was one death classified as being due to pregnancy, childbearing or associated therewith. 11 Comparative Statistics of Births, Mortality, etc. 1936 to 1955 Live Births Still Births Deaths Infant Deaths Maternal Deaths Year Population No: Rate* No: Rate† No: Rate* No: Rate§ No: Rate † 1955 61380 694 11.4 11 15.6 649 9.7 12 17.3 1 1.42 1954 61550 703 11.3 15 20.9 610 9.9 10 14.2 1 1.39 1953 61540 791 12.9 11 13.7 643 10.4 20 25.2 - - 1952 61880 751 12.1 10 13.1 666 10.8 17 22.6 1 1.31 1951 61850 768 12.4 21 26.6 668 10.8 11 14.2 2 2.54 1950 62460 847 13.5 22 25.3 605 9.6 16 18.9 1 1.15 1949 62010 839 13.5 22 25.5 687 11.0 31 36.9 1 1.2 1948 61150 977 16.0 20 20.1 618 10.1 32 32.7 1 1.0 1947 60280 1199 19.8 29 23.6 660 10.9 37 30.8 1 0.8 1946 57570 1117 19.2 22 19.3 611 11.1 35 31.3 3 2.6 1945 48230 759 16.0 15 19.3 627 13.0 24 31.6 1 1.29 1944 46670 878 18.8 24 26.6 591 12.8 27 30.7 - - 1943 50010 857 17.1 18 20.5 583 11.6 37 43.1 3 4.57 1942 49850 803 16.1 17 20.7 572 11.4 21 26.1 1 1.2 1941 46640 566 12.1 20 34.1 551 11.1 15 30.2 1 1.7 1940 48620 611 12.6 22 34.7 653 13.4 18 31.8 - - 1939 55880 763 13.7 36 45.1 555 10.1 28 37.8 2 2.7 1938 54810 744 13.6 20 26.2 521 9.5 23 30.9 - - 1937 53840 720 13.4 29 38.8 522 9.7 29 40.3 - - 1936 52010 699 13.4 30 41.1 471 9.1 27 38.6 2 2.7 *Per 1,000 Population †Per 1,000 Total Births §Per 1,000 Live Births 12 SECTION B GENERAL PROVISION OF HEALTH SERVICES 1. Public Health Officers of the Authority See page two. 2. Laboratory Facilities Pathological and bacteriological services are provided at the Pathological Laboratory, St. Margaret's Hospital, Epping. The analysis of water, milk and food is carried out by Dr. J. H. Hamence and Mr. George Taylor, Public Analysts for the Borough, and by the Counties Public Health Laboratories. 3. Infant Welfare Centres There are six infant welfare centres in the Borough, sessions being held as under:— Baptist Church Hall, Aldersbrook, E.12. Monday, 2.30—4 p.m. Ashton Playing Fields Pavilion, Woodford Bridge. Tuesday, 2.30—4 p.m. St. Barnabas Church Hall, Snakes Lane, Woodford Green. Wednesday, 2.30—4 p.m. Fullers Road Sunday School, South Woodford, E.18. Wednesday, 2.30—4 p.m. Cromwell Hall, Nightingale Lane, Wanstead, E.11 Thursday 2.30—4 p.m. Holy Trinity Church Hall, Hermon Hill, South Woodford, E.18 Friday, 2.30—4 p.m. 4. Ante-Natal Clinic 118 Hermon Hill, Wanstead. Thursday, 2.30—4 p.m. 5. School Clinic, 93 High Road, Woodford Dental—By appointment only. Minor Ailments—Every Friday morning. †Ophthalmic—Wednesday mornings, By appointment only. †Orthopaedic—First Thursday afternoon in each month. By appointment to see Surgeon only All day Tuesday and Thursday afternoon. For after-treatment by appointment only. Speech Therapy—Monday and Wednesday only during school term. By appointment only. † Controlled by the North East Metropolitan Regional Hospital Board and delegated to the Forest Group Hospital Management Committee. 13 6. Chest Clinic Harts Hospital, Woodford Green. Sessions: Wednesday, 9.15—11 a.m. 5.0—6.0 p.m. (appointment only) Friday, 9.15—11 a.m. Refill sessions: Tuesday and Thursday, 2 p.m. B.C.G. Vaccinations—Saturday morning, once monthly. (by appointment only). 7. Ambulance Facilities These facilities are available through the local depot at Wanstead, the service being administered centrally by the County Council from Chelmsford. 3. National Assistance Act, 1948 (Section 47) No action became necessary to secure the removal of persons in need of care and attention to suitable premises during 1955. 9. Funeral arrangements In no cases was the Local Authority required to make arrangements for the burial of a person during the year 1955. SECTION C SANITARY CIRCUMSTANCES OF THE AREA 1. Water Supply The water supplied throughout the Borough by the Metropolitan Water Board was satisfactory both in regard to quality and quantity. Regular monthly bacteriological examinations are carried out by the Metropolitan Water Board, the examinations being of raw and treated water. The results obtained from treated water were satisfactory. Copies or these reports are received regularly from the Board. 2. Refuse and Salvage Collection (a) Refuse Collection A fleet of Shelvoke and Drewry freighters is operated for the collection of refuse and disposal is by means of controlled tipping. The collection service is organised on the basis of three teams working the relay system—each team covering one third of the Borough each week. (b) Salvage Collection The separate collection of waste paper for salvage has been continued. 14 Sewerage Many of the very old sewers in the Western Drainage area require reconstruction and some of these have been relaid. A programme for the remainder has been drawn up, phasing the work over several years. Many lengths of sewer in the Borough have insufficient manholes and on some sections such facilities are completely lacking. A programme has, therefore, been prepared for providing manholes where considered desirable and a number are being provided each year. Eastern Sewage Disposal Works. The top two feet of media on four of the six filter beds was renewed, to be followed by the installation of experimental recirculation of effluent. Alternative methods of strengthening the supports of the distributor rails at the rectangular filter beds were examined and an inexpensive scheme eventually decided upon. During the year various aspects of the operation of the sewage works were investigated with a view to further improving the standard of effluent. It was decided that certain improvements would have to be undertaken as soon as practicable. , Southern Sewage Disposal Works Severe limitation of technical staff prevented the commencement of work on the major scheme of extension and improvement as early as had been hoped. Meanwhile preparation of the detailed proposals proceeded as well as the above limitation allowed. Western Sewage Disposal Works. Following negotiation with Chingford Borough Council with respect to financial arrangements for the diversion of sewage from the western drainage area to Chingford, that Council proceeded with the construction of the necessary relief sewer, of which Wanstead and Woodford Borough Council bears an appropriate portion of the cost. At western sewage works, construction of the connecting sewer, storm overflow and ancillaries commenced in readiness for the diversion of sewage to take place early in 1956. 15 SANITARY INSPECTION OF THE AREA The Chief Sanitary Inspector reports as follows:— Insanitary Dwellings—Housing Act, 1936 Previous Annual Reports have recorded the services rendered by a Sub-Committee of the Public Health Committee in visiting substandard dwellings, it is therefore possible to state that this same sub-committee (Councillors Mrs. S. V. F. Ashton, R. A. Dalton and S. J. Relph) continued to serve and twenty-four visits were made by them. It may be well to follow the lines of last year's Report and deal with properties mentioned therein. 98 and 109 High Road, Woodford Bridge. These two old buildings, constructed mainly of timber, were demolished in 1955. 1, 2, 3 and 4, Waller's Cottages, Woodford Bridge. Also demolished in 1955. 1—10, Burlington Place. As mentioned in the Report of the Medical Officer of Health for 1954, an enquiry was held at the Municipal Offices at which objections to a Clearance Order by one owner and two owner occupiers were heard. It can now be recorded that the Minister supported the Council and its Officers and confirmed the Order. Allowances were made for good maintenance under Section 42 of the Housing Act, 1936, concerning houses Nod. 1 and 4. 99—125, 129—169, Chigwell Road. In the Report for 1954 it was possible to give details up to the time of the public enquiry, consequently it is pleasing to report that the Official Representation by the Medical Officer of Health was accepted and confirmation of the Clearance Order made by the Minister of Housing and Local Government. 174, 176, 178, 180, 182, 184, Hermon Hill. These dwellings, the subject of a Clearance Order were demolished during the latter part of 1955. 9 & 10 Belgrave Terrace. These properties, on which Closing Orders were made remained unrepaired although suggestions for reconditioning were made. 5, 6, 7, 8, 9, Inmans Row were represented to the Council by the Medical Officer of Health as being property suitable for making a Clearance Area. 16 99, High Road, E.18. This old partially timbered dwelling, the subject of a voluntary undertaking was still unrepaired and unoccupied. 103, High Road, E.18. Although it is usual for the Council to rehouse occupiers of condemned houses it was decided not to do so in this case. It was necessary to evict the tenant upon a Court Order (an unpleasant task) and to obviate its re-occupation the owner immediately took steps to demolish the building. As is very often the case with very old wooden buildings, the front view of this dwelling was not unsightly, but demolition exposed the true condition of the structure which in this case was worm-eaten, perished and thoroughly dilapidated. Again it is well known that the presence of furniture conceals defects internally. The Bungalow, Hepworth House, Whitehall Road, the subject of a Demolition Order was in the process of being demolished at the end of the year under review. 53, and 55, High Road, Woodford Bridge were demolished as were 39 and 41, Globe Road. One house has been built on the sites of the former and two on the latter. 1—11, Radleys Lane were considered by the Public Health Committee and Demolition Orders made. The houses were subsequently lemolished by the owners. 7, Hall Road was reported to the Public Health Committee as being suitable for consideration in connection with Section 11 of the Housing Act, 1936. The owner appeared before the Committee and offered to carry out certain works of repair and improvement and the works were subsequently carried out. 1, 3, 5 and 7, Gainsborough Road forming two semi-detached pairs of 3-storied houses were found to be in such a condition that action under Section 11 of the Housing Act was appropriate. Notices were served on interested parties who made no representation to the Council indicating the future of the dwellings and Demolition Orders were duly made on all four houses. 11, 13, 15 and 17, Voluntary Place had been considered on many occasions as being suitable for action under the Housing Act but because of the cost involved in rebuilding the front walls and reported to have been paid for by the War Damage Commission, consideration of their future had been deferred. After further 17 surveys it was thought that delay in dealing with them under the Act could no longer be allowed, consequently they were reported to the Public Health Committee and in July, Demolition Orders were made. 33, High Road, Woodford Green, a large 3-storied house was dealt with under section 11 and a Closing Order made. 1—27, Sultan Road. A block of properties of which 25 were considered suitable for dealing with as a clearance area. The two exceptions, Nos. 26 and 27 were found to be in a good condition, this being accounted for by the fact that they were built many years after the others. An Official Representation was made in December covering the 25 properties to which reference has been made. 160 and 162, High Road, Salway Hill. These two old wooden cottages were reported upon and action taken in accordance with Section 11. Demolition indicated just how bad these cottages were. Aldersbrook Hutted Camp. The Annual Report for 1954 gave a full account of this hutted camp which showed what a blot on the landscape it was. It can, therefore, be appreciated that its use for another year did not improve conditions existing there. Of the 29 huts, 21 were vacated by the end of 1955 and it is hoped that before the end of another year the remainder will be unoccupied. Housing Repairs and Rents Act, 1954. The fact that only eleven applications for certificates of disrepair were received during the year indicated one of two things; either that the tenants upon whom notices of increase in rents were served were content with the higher rents or that the houses were in good repair. There is the possibility that many owners have failed to serve notices of rent increase because they have realised the expense to which they will be put in order to place the houses in good repair. In connection with the eleven applications, eleven certificates of disrepair were granted, one of which was later revoked. One tenant, the holder of a certificate, purchased the house, thus transferring all responsibilities from the former owner to himself. Two more certificates were granted in connection with two applications made in December, 1954. Both of these were revoked in 1955. 18 Overcrowding. One case of overcrowding was reported to the Public Health Committee concerning a family from India who found accommodation in one room in a house of a fellow countryman. The necessary notices were served, with the result that the owner obtained posesssion of the room. The family were later housed in one of the "half-way" houses under control of the Council. Once again close co-operation existing between the Public Health and Housing Departments can be recorded; this is most helpful when dealing with rehousing of families from unfit houses. In dealing with matters in connection with clearance areas and unfit houses it is unusual to receive letters of appreciation from families rehoused. However, in March a letter was received from a tenant whose house came within the scope of a clearance area, expressing appreciation for help given by the Council. The services of the Local Authority and their Officers are so often accepted as a matter of fact. Offence under the Public Health Act, 1936 A complaint was received from the occupier of a house whose neighbour kept chickens in a glasshouse at the rear of his garden. The glasshouse was only a matter of some five feet away from the complainant's flank wall. Upon inspection it was found that about three dozen chickens were kept in this glass and wood structure— which measured approximately 10ft. by 8 ft. the interior of which was in a filthy condition. Appeals to the owner of the birds to reduce their number and to cleanse the interior of the structure proved to be futile, so the Council had no alternative but to take action against him in the magistrates' court. An order to abate the nuisance was granted and costs were allowed amounting to two guineas. Essex County Council Act, 1933, Section 109. This section makes it an offence to place or keep on land a moveable dwelling without the previous approval of the Local Authority. One application to place and keep on land a caravan was received the application being deferred so that an inspection could be made by the Medical Officer of Health. Before further consideration could be given to the matter the applicant obtained alternative living accommodation and removed the caravan. 19 Public Health Act, 1936, Section 101. The residents of a block of dwellings near a small foundry complained of nuisance from smoke when smelting was taking place. No nuisance could be seen when observations were made. The proprietor was interviewed on several occasions and he explained that smoke in small quantities could be given off, if at all, only when the furnace was first started up. In spite of the observations mentioned above the proprietor changed the fuel from coke to gas, which appeared to remove the cause for complaint. Meat Inspection. Because of the visits made by the Deputy Chief Sanitary Inspector it was ascertained that carcase meat was being brought into a local wholesale meat store largely uninspected. Meat arriving early in the morning from a town in Lincoln for local sale was found on a number of occasions to be diseased or otherwise unfit. This, in November, necessitated setting up a system of early morning inspections in which two inspectors took part. The number of carcases inspected from November 11th, 1955 until the end of the year is given below:— Cows 133 Pigs 1288 Bullocks 122 Sheep 163 Calves 65 Lambs 621 Boars and Sows 17 The amount of meat and offal found to be unfit by the inspectors and surrendered by the wholesale firm was 468 pounds. Work in Default Housing Act, 1936, Section 9. In three cases only was it necessary to do work in default and in these the amounts involved were not high, being £20. 5. 0, £68. 18. 0, and £46. 11. 2. Public Health Act, 1936. It was not necessary to take proceedings and do work in default upon a Court Order in regard to housing repairs under this Act. Other work executed by the Local Authority. Work to drainage systems was carried out in three cases under Section 24 (public sewers) of the Public Health Act, 1936 and in four cases under Section 39 (drains) of that Act. 20 Notices were served under Sections 24 and 39 of the Public Health Act, 1938 in connection with drainage systems to seven houses and to a block of flats. Appeals in both cases were lodged at the Court of Summary Jurisdiction against the work required, but they were withdrawn before the hearing. Smoke Abatement. Reference to the Annual Report of the Medical Officer of Health for the year 1954 shows that recordings were made of pollution in the atmosphere by the use of a daily recording instrument which made it possible to measure the amount of smoke or suspended matter and the quantity of sulphur dioxide. This work was continued throughout the year. The table below indicates the readings made during the twelve months under review:— Month Smoke (mg/l00m3) Sulphur Dioxide (p.p. 100m) Average Highest Lowest Average Highest Lowest January 47 153 15 11 38 2 February 27 72 8 7 19 3 March 13 28 4 5 10 2 April 12 31 2 6 16 1 May 7 16 1 3 4 0.8 June 4 9 1 2 3 0.7 July 2 4 1 1 2 0.5 August 5 13 1 2 3 0.4 September 7 15 2 3 7 1 October 17 51 5 5 18 2 November 44 92 17 8 33 2 December 43 130 12 10 34 3 21 Some further figures are given below which deal with smoke and sulphur dioxide recordings and will be found useful in connection with the above table:— Smoke:— Average for year 19 Average for winter months 32 Average for summer months 6 Highest daily recording 153 Lowest daily recording 1 Sulphur Dioxide:— Average for year 5.5 Average for winter months 8 Average for summer months 3 Highest daily recording 38 Lowest daily recording 0.4 Pollution Measurement in "Smog" During 1955 it was agreed with the Fuel Research Station that at "Smog" periods additional readings would be taken. The Fuel Research Station receive warnings from the Meteorological Office, notify us and the readings are then taken at approximately 9.00, 12.00 14.00 and 16.00 hours. Fog was experienced on November 30th and December 1st with the following readings:— Date Time Smoke (mg/100m3) Sulphur Dioxide (p.p.100m) November 30th 9.30 41 11 12.0 126 37 14.00 126 53 16.15 76 32 December 1st 9.00 72 21 11.45 54 20 The Fuel Research Station notified that the "smog" period was over so no more special readings were taken, but the fog re-appeared fairly dense, at night, and the day after the reading was as follows: December 2nd 13.45 130 34 22 Another fog period occurred in January, 1956, with these results: Date Time Smoke (mg/100m3) Sulphur Dioxide (p.p. 100m) 1956 January 5th 9.00 115 36 12.00 51 18 14.00 77 28 16.00 54 24 January 6th 9.00 72 18 12.00 20 8 Fog cleared. Although neither of these fog periods approached the density or length of the 1952 "smog", the above figures show the marked increase over the average figures in both smoke and sulphur dioxide. 23 PUBLIC HEALTH EXHIBITION, APRIL, 1955 The Public Health Committee, upon the recommendation of the Medical Officer of Health decided to hold a Public Health Exhibition and in January proposals were put forward by him for this to be held on April 14th, 15th and 16th in the new public hall at Woodford Green. The availability of this new hall—the Sir James Hawkey Hall—gave much scope to the setting of such an exhibition, therefore it was decided to set up as many sections as possible dealing with public health work carried out in the Borough. Sections dealing with housing, smoke abatement, food inspection and hygiene, home safety, rodent control and maternity and child welfare were finally selected. Under the guiding hand of the Medical Officer of Health each Officer of the Sanitary Inspector's section of the Public Health Department was responsible for a section of the exhibits and all were given a reasonably free hand to obtain both working and static models, charts, graphs and photographs. The exhibition showed what team work can produce with the result that the hall contained exhibits which interested the visitors both young and old. A film section in the lounge was appreciated by many of the 3,000 visitors who saw films dealing with food poisoning, smoke abatement, child care, etc. To make this section such a success the Department had the valuable assistance of the Road Safety Officer who aranged the showing of various films, and success was proved by the fact that the lounge was filled to capacity at every showing. We were fortunate in obtaining from private firms, Government Departments and societies interested in the various sections many models and items of equipment. The Department was very appreciative of the co-operation of the many organisations approached to this end. It would be difficult and even unfair to spotlight any particular exhibit because young and old showed so much interest in everything from cabinets with living flies to model hygienic kitchens. One interested party was made up of students from a nearby hospital. In preparing the materials for the exhibition we had in view the need to make the exhibition real and live, and in this direction we appear to have succeeded because all sections had a number of working models and apparatus. For instance there was a model which produced smoke to clothe the surrounding buildings with smog, mechanical book for Home Safety posters, etc. The Ministry of 24 Agriculture and Fisheries stand with live rats and mice was a great attraction to the younger folk. Great interest was taken in the models for housing and in exhibits of unsound foods, particularly in the case of tubercular meat supplied by the Chief Sanitary Inspector of Romford. Great use was made of photographs showing the Council's activities in clearing away unfit dwellings. The Parks Superintendent of the Borough Engineer and Surveyor's Department produced fine floral displays which added to the attractiveness of the whole. It was pleasing to see among the visitors familiar faces of colleagues who discussed many points with the Public Health Department Staff. Many new friends were also made, which is all to the good. The many months of hard work put into producing such an Exhibition was compensated for by the support given by the Council—in particular the Public Health Committee and by the encouraging attendance of the public. The staff of the Public Health Department were in attendance for the whole time. CIVIC EXHIBITION, AUGUST, 1955. On August 20th a Civic Exhibition was held at the Municipal Offices, Woodford, to commemorate the formation of the Borough. The offices were open to the public on the Saturday afternoon and evening during which time the various Departments arranged exhibits which would be of interest to the visiting ratepayers. In spite of the lack of space, the Public Health Department produced items thought to be topical and put on small displays dealing with food hygiene, smoke abatement, rodent control and safety in the home. So as to give assistance and explanation to the public, inspectors manned the exhibition throughout its duration. 25 Rodent Control The work in connection with the destruction of rats and mice has continued, the Council still employing one full-time operative. From the figures given below it will be noted that the number of complaints received has risen from 324 in 1954 to 410 in 1955, an increase of close on 30 per cent. Visits increased from 799 to 860, whilst inspections made by sanitary inspectors increased from 144 in 1954 to 217 in 1955; a 50 per cent increase. Comment was made on the slight increase in the complaints received in 1954; unfortunately a greater increase is noted for 1955,j from which one can safely conclude that the rodent population has still to be considered a menace. Again if one studies the figures from 1947 onwards it is noted that the number of complaints has been creeping up steadily. The increase in the number of visits by the sanitary inspectors confirms that the fight against rats and mice is still something to reckon with and a fight which must not be relaxed by Local Authorities. Good relationship still exists between the Officers of the Local Authority and Officers of the Ministry of Agriculture and Fisheries, and the meetings of the Workable Area Committee held three times per year still give scope for useful discussion. The number of complaints received in the past is as follows: 1947 139 1948 210 1949 287 1950 284 1951 290 1952 330 1953 316 1954 324 1955 410 Appreciation should be recorded of the co-operation given by the Borough Engineer and Surveyor and his Department in providing the necessary gang for the work on sewer treatment. A quick review of the results of the treatment for 1955 shows an improvement on the years 1953 and 1954 which should indicate a lower rat population in the sewers. The usual detailed charts are given on the following pages. Surface Treatment: The following table shows the result of the year's work. Number of inspections made by the Sanitary Inspectors 217 Complaints received 410 Retreatments — Revisits to premises 343 Visits to adjacent premises 117 Total premises visited 860 Number of baiting points 3555 Rats found dead 78 26 Sewer Treatment FIRST TREATMENT 1 2 3 4 5 6 7 8 Section No. of Manholes No. not Baited No. Baited Average Pre-bait takes Completed Partial Total takes NT 1. 72 3 69 25 23 48 21 2. 87 2 85 31 21 52 33 3. 73 — 73 23 25 48 25 4. 74 — 74 23 23 46 28 5. 71 — 71 17 13 30 41 6. 79 1 78 19 15 34 44 7. 76 — 76 21 16 37 39 8. 67 — 67 22 10 32 35 9. 78 2 76 23 10 33 43 10. 77 — 77 17 9 26 51 11. 69 — 69 19 15 34 35 12. 70 — 70 21 13 34 36 13. 71 — 71 28 14 42 29 14. 67 - 67 25 14 39 28 15. 75 - 75 18 14 32 43 16. 71 - 71 29 14 43 28 17. 68 — 68 21 11 32 36 18. 72 - 72 22 11 33 39 19. 71 3 68 23 12 35 33 1388 11 1377 427 283 710 667 27 Sewer Treatment SECOND TREATMENT 1 2 3 4 5 6 7 8 Section No. of Manholes No. not Baited No. Baited Average Pre-bait takes Completed Parti Total takes #] 1. 71 - 71 14 20 34 37 2. 86 - 86 11 19 30 56 3. 71 - 71 9 14 23 48 4. 74 - 74 13 19 32 42 5. 77 - 77 8 19 27 50 6. 79 9 70 8 20 28 42 7. 77 - 77 9 18 27 50 8. 67 - 67 6 22 28 39 9. 79 5 74 12 24 36 38 10. 77 2 75 3 11 14 61 11. 69 - 69 9 16 25 44 12. 70 - 70 8 19 27 43 13. 71 1 70 7 20 27 43 14. 68 68 4 32 36 32 15. 75 — 75 7 14 21 54 16. 70 6 64 9 29 38 26 17. 68 10 58 5 18 23 35 18. 72 — 72 10 22 32 40 19. 71 - 71 7 15 22 49 1392 33 1359 159 371 530 829 28 Summary of Treatments Year No. of Manholes No. NOT baited No. baited Average Pre-bait Takes. Complete Partial Total takes N.T. 1955 1st treatment 1388 11 1377 427 283 710 667 2nd „ 1392 33 1359 159 371 530 829 1954 1st treatment 1396 24 1372 468 161 629 743 2nd „ 1390 39 1351 404 242 646 705 1953 1st treatment 1409 3 1406 550 294 844 562 2nd „ 1408 52 1356 407 367 774 582 1952 1st treatment 1419 5 1414 604 276 880 534 2nd „ 1418 — 1418 460 337 797 621 1951 1st treatment 1419 619 800 240 115 356 444 2nd „ 1419 19 1400 284 141 425 975 1950 1st treatment 1405 12 1393 210 85 295 1098 2nd „ 1396 33 1364 280 140 423 942 29 Pet Animals Act, 1951 There were in 1955 four registrations. Inspections were made of the premises during the year, the shops all being maintained in a satisfactory condition. Rag Flock and Other Filling Materials Act, 1951 No additional registrations have been made under this Act, the number of premises registered in the Borough remaining one. Petroleum (Regulation) Acts, 1928 and 1936 The number of licences renewed remained at 58, the same as that reported for 1954. A local electrical firm increased its storage facilities from 500 to 1,000 gallons by installing another underground tank, the whole being used in connection with their business. One additional pump was also installed. One of the large garage—cum—petrol service stations added two further tanks to their existing installation which increased the storage capacity by 3,000 gallons. Additional pumps were installed and existing ones re-arranged. Petrol pumps were re-arranged when another service station was taken over by a new management. 84 inspections were made during the year. Game Licences. Eleven licences to deal in Game were renewed in 1955. The Milk (Special Designations) (Pasteurised and Sterilised Milk) Regulations, 1949 and 1953 and Raw Milk Regulations. The following licences were issued: Dealers Licences.: Pasteurised 12 Sterilised 21 Tuberculin Tested 12 Supplementary Licences: Pasteurised 9 Sterilised 9 Tuberculin Tested 9 30 Clearance Order: 5, 6, 7, 8 and 9 Inmans Row, Woodford Green. Showing a picturesque row of buildings (note buttresses on right hand side of photograph). Clearance Order; 5, 6, 7, 8, 9, Inmans Row. A view of the back of the dwellings taken from house at end with buttresses — a contrast to the picturesque front. Clearance Order: 1-25 Sultan Road. The two houses at the end of the road (front view) were excluded, being in better condition. A corner oF Sultan Road not visible from the view taken at the end of the road, (note defective View of back addition to a house in Sultan Road showing general dilapidation. Public Health Exhibition, April, 1955. Public Health Exhibition, April, 1955. Public Health Exhibition, April, 1955. Shops Act, 1950 A considerable increase in the inspection of shops should be noted (222 in 1955 as against 77 in 1954) although this does not indicate difficulties in working the Act. No difficulty has been experienced with the closing hours of shops. Office and other workers find difficulty in shopping after they leave their place of employment because of the punctual closing. One shop was fitted with additional sanitary accommodation. fcssex County Council Act, 1933 Massage and Special Treatment Establishments. As in previous years the Sanitary Inspectors carried out the usual routine inspections to these premises. They were all found to be quite satisfactory. Eleven visits were made during the year. storage of Explosives The Essex County Council referred to this Council details of proposals by a large manufacturing firm to store a considerable quantity of explosives, i.e., magnesium flares, and a visit was made to the site together with an Officer of the County Fire Service. Apparently after further consideration the firm decided not to proceed with the project although it is understood that they had proposals for building the store elsewhere. Swimming Bath Water Although the Borough does not possess a public swimming bath nor is there one within its boundaries, there are three baths belonging to schools and one to a children's home. Samples were taken from each of these during the year, the Public Health Laboratories reporting favourably thereon. Two samples of water from local ponds used for swimming were reported upon rather unfavourably, although the condition of the water was not sufficiently bad to warrant the erection of notices banning their use for swimming. nspections carried out by Sanitary Inspectors. Infectious Disease enquiries, including enquiries in respect of scabies 51 Visits in connection with contacts, disinfection, etc 39 Enquiries in connection with food poisoning 25 Verminous Premises 16 31 General Environmental Public Health Drains and Sewers inspected Drain tests applied 773 Stables and manure pits inspected 28 Public Conveniences 17 Overcrowding 11 Factories (mechanical) 151 Factories (non-mechanical) 15 Hairdressers' premises 23 Schools 44 Ditches, Streams and Ponds 85 Open spaces and Playing Fields 24 Petrol Installations 84 Shops Act inspections 222 Outworkers premises 38 Massage Establishments 11 Pet Animals Act 4 Merchandise Marks Act 10 Swimming Baths 15 Smoke observations 10 Workplaces 13 Housing Repairs and Rents Act 89 Miscellaneous 163 Inspection of Food Premises Meat Shops 198 Bakehouses 55 Fishmongers 34 Grocers 135 Restaurants and Cafes 65 Dairies and Milk Shops 14 Greengrocers 43 Ice Cream Premises 26 Street Vendors 1 Fish Fryers 2 Food and Drugs Sampling 73 Ice Cream Sampling 40 Milk Sampling 16 Cooked Meats 1 TOTAL 2533 32 SECTION D. HOUSING No. of dwellings erected during 1955: 88 Council; 69 Private enterprise; No Cost of Works (rebuild) 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) 2026 (b) Number of inspections made for the purpose 2215 VISITS (2) (a) Number of dwelling houses (included under sub-head (1) above) which were inspected and recorded under the Housing Consolidated Regulations, 1925 and 1932 - (d) Number of inspections made for the purpose - (3) Number of dwelling-houses found to be in a state so dangerous or injurious to health as to be unfit for human habitation 12 (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 142 2. Remedy of Defects during the year without service of formal notices:- Number of defective dwelling-houses rendered fit in consequence of informal action by the Local Authority or their Officers 135 3. Action under Statutory Powers during the year:- (a) Proceedings under Section 9, 10 and 16 of the Housing Act, 1936: (1) Number of dwelling-houses in respect of which notices were served requiring repairs 9 (2) Number of dwelling-houses which were rendered fit after service of formal notices: (a) By owners 7 (b) By Local Authority in default of owners - (b) Proceedings under Public Health Acts: - (1) Number of dwelling-houses in respect of which notices were served requiring defects to be remedied 38 (2) Number of dwelling-houses in which defects were remedied after service of formal notices: (a) By owners 32 (b) By Local Authority in default of owners 33 (c) Proceedings under Section 11 and 13 of the Housing Act, 1936: — (1) Number of dwelling-houses in respect of which Demolition Orders were made 17 (2) Number of dwelling-houses demolished in pursuance of Demolition Orders 11 Nuisances Abated and Improvement Effected Roofs repaired 43 External walls and chimney stacks repaired 33 Walls underpinned 1 Gutters and spouts repaired or renewed 33 Damp-proof courses provided 6 Dampness remedied 59 Yards paved or repaired 1 Internal walls and ceilings repaired 57 Doors and frames repaired or renewed 8 Windows repaired or renewed 41 Roofs repaired or renewed 16 Sub-floor ventilation provided or improved 1 Rooms cleansed or redecorated 6 Fireplaces and flues repaired or renewed 15 Washbasins and sinks provided or renewed 7 Wastepipes repaired or renewed 13 Dustbins provided or renewed 2 Water supply improved or reinstated 8 Water closet pans repaired, renewed or cleansed 7 Water closet cisterns repaired or renewed 12 Water closet lighting and ventilation improved 1 Water closet flush pipe joints repaired 1 Water closet walls etc., cleansed 4 Water closet structures repaired 4 Drains cleansed from obstruction 166 Drains repaired or renewed 19 Miscellaneous 3 Disinfection and Disinfestation Number of rooms disinfected 55 Premises from which bedding removed for steam disinfection 51 Essex County Council Act, 1952 During the year one person was registered under Section 103 of the above Act as a Hawker of Food. 34 FACTORIES ACT, 1937 1. Inspections for the purposes of provisions as to health (including Inspections made by Sanitary Inspectors). Premises (1) Number on Register Number of Inspections Written notices Occupiers prosecuted (i) Factories in which Section 1, 2, 3, 4 and 6 are to be enforced by Local Authorities 39 15 - - (ii) Factories not included in (i) to which Section 7 applies 151 160 5 - (iii) Other Premises under the Act (excluding out-workers' premises) - - - - TOTAL 190 175 5 - 2. Defects found. Particulars Number Found of Defects Referred by H.M. Remedied Inspector Number of defects in respect of which Prosecutions were instituted Want of Cleanliness 3 3 1 - Overcrowding - - -- - Unreasonable temperature - - - - Inadequate Ventilation - - - - Ineffective drainage of floors - - - - Sanitary Conveniences:- 1 Insufficient - - - - 2 Unsuitable or defective 2 2 - - 3 Not separate for sexes 1 - 1 - Other Offences - - - - TOTAL 6 5 2 - 35 3. Outwork Number of out-workers in August list required by Section 110(1) (c) Paper Bags 6 Boxes 14 20 Four certificates of means of escape in case of fire under Section 34 were issued in 1955 and three were amended. 36 SECTION E. FOOD AND DRUGS ACT, 1938 Three prosecutions were made during the year. These were in respect of a cigarette end in a loaf of bread and two for mould in meat pies. In each case the fine was £5. The Public Health Committee decided to write to a dairy firm where they received a report that solid matter was found in a bottle of milk. The meat content of the samples of pork sausages varied between 65 per cent and 80 per cent. The sample of oranges was free from thiourea. Seven ice lollies showed a lead content not exceeding 1 p.p.m. A list of food samples is given below: Brandy 2 Honey 1 Gin 3 Ice Cream 5 Rum 2 Ice Lollies 7 Whisky 9 Lard 3 Bacon 4 Lemon Juice 2 Beef Dripping 1 Milk 12 Butter 11 Mixed Peel 1 Butter Almonds 1 Mixed Spice 1 Butter Mints 1 Muscatels 1 Buttered Walnuts 1 Oranges 1 Candied Peel 1 Plum Jam 1 Coffee 3 Pork Sausages 7 Corned Beef 1 Preserved Ginger 1 Cream 1 Raisins 1 Currants 2 Spanish Black Figs 1 Curry Powder 1 Steak Pies 1 Dates 1 Stuffed Pork 1 Double Cream 1 Sultanas 1 Dried Bananas 1 Tea 6 Dried Peaches 1 Ammoniated Tincture of Figs 1Quinine 1 Fish Cakes 2 Boric Ointment 1 Flour 1 Camphorated Oil 1 Fruit Salad 1 Cod Liver Oil Emulsion 2 Ground Almonds 2 Glycerine 1 Ground Nutmeg 1 Liquorice Powder 1 Ham 1 Olive Oil 1 Cod Liver Oil 1 120 Five samples of ice cream were submitted to the Public Analyses to ascertain the fat content of the mixture. These samples contained fat to the following extent: 13.2 per cent. 12.8 per cent. 11.1 per cent. 12.9 per cent. 9.6 per cent. 37 The following is a list of foods surrendered in 1955 because of unsound conditions: Fish, Fresh Meat, Tinned Catfish 4 stone Luncheon Meat 84 tins Whiting 2 stone Meat Loaf 1 tin Skate 13 stone Corned Beef 67 tins Melts 2 stone Ham 4 tins Pork 4 tins Fish, Tinned Meat Pudding 2 tins Stewed Steak 5 tins Salmon 6 tins Ox Tongue 4 tins Crab 58 tins Liver 1 tin Pilchards 4 tins Fruit, Tinned Meat, Fresh Apples 1 tin Pigs Heads 79 lbs Plums 9 tins Beef 480½ lbs Pineapples 31 tins Mutton 34 lbs Peaches 21 tins Lamb 40 lbs Apricots 8 tins Offal 57 lbs Oranges 8 tins Pork 22 lbs Pears 3 tins Pork Sausages 1 lb Gooseberries 2 tins Liver 585 lbs Strawberries 1 tin Bacon 46 lbs Fruit Salad 7 tins Veal 267 lbs Grapefruit 1 tin Blackberries 1 tin Miscellaneous Fruit, Fresh Pears 70 lbs Milk 23 tins Raspberries 22 lbs Cheese 156 lbs Cheese 4 pkts Fruit, Dried Soup 7 tins Cream 4 tins Sultanas 190 lbs Coffee 3 tins Currants 72 lbs Jam & Marmalade 3 jars Prunes 30 lbs Ketchup 6 jars Paste 9 jars Vegetables, Tinned Tomato Juice 1 tin Macaroni 8 tins Peas 45 tins Pickles 3 jars Beans 17 tins Porage Oats 5 pkts Carrots 2 tins Jelly 1 pkt Tomatoes 14 tins Creamed Rice 2 tins Vegetables, Mixed 1 tin Pepper 12 ozs 38 MANUFACTURE, STORAGE AND SALE OF ICE CREAM Eighty-three registrations of premises were in force at the beginning of the year, and a further four were added during the year. Twenty-six visits to premises were made during the year in addition to forty visits for the purpose of obtaining ice cream samples. Ice-Cream Samples (Bacteriological Examinations) Fourteen samples of ice-cream and ice-lollies were obtained and found to be satisfactory. The number of samples has again been reduced this year due to the fact that the bulk of such product is made by the large manufacturers whose standard is of the highest. Further, the major part of the sales are wrapped. Foods and Drugs and Bacteriological Examinations As in former years, the Food and Drugs samples were submitted to Messrs. Bernard Dyer and Partners Ltd., (George Taylor, Esq., F.R.I.C., Dr. J. H. Hamence, F.R.I.C., and P. S. Hall, Esq., A.R.I.C.) of 20 Eastcheap, London, E.C.3 and samples for bacteriological examination to the Counties Public Health Laboratories (Roy C. Hoather, Esq., B.Sc., Ph.D., F.RI.C., F.R.San.I.; W. A. Bullough, Esq., C.B.E., M.Sc., M.B., Ch.B., D.P.H., and Gordon Miles, Esq., B.Sc., F.R.I.C., M.R.San.I.) 66, Victoria Street, London, S.W.I The Department is appreciative of the help given by these two Laboratories during the year. 39 SECTION F. PREVALENCE OF, AND CONTROL OVER, INFECTIOUS AND OTHER DISEASES The following table shows the incidence of infectious disease during he year, together with the number and percentage of cases admitted o hospital and the number and percentage of deaths:— Disease Total Notified Removed to Hospital Per cent Removed to Hospital Deaths Deaths per cent of cases Notified Smallpox - - - - Scarlet Fever 17 1 6 - - Diphtheria - - - - - Pneumonia 13 2 15.2 - - Cerebro-Spinal Fever - - - - Acute Poliomyelitis 12 12 100 - - Acute Polioencephalitis — — — — Encephalitis Lethargies - - - - - Dysentery 2 1 50 - - Puerperal Pyrexia 42 411 97.6 - - Paratyphoid Fever - - - - Enteric or Typhoid Fever - - - - - Erysipelas 4 - - - - Malaria (contracted abroad) - - - - - Measles 938 17 1.8 - - Whooping Cough 20 - - - - Ophthalmia Neonatorum - - - - - Food Poisoning 29 - - - - †These cases all occurred in hospital. 40 These cases of infectious disease have been divided into age incidence and set out in the accompanying table:— Disease All Ages Under lyr. 1-5 yrs. 5-10 yrs. 10-15 yrs. 15-25 yrs. 25-45 yrs. 45-65 yrs. 65 & yrs. Scarlet Fever 17 1 3 10 3 - - - - Pneumonia 13 - - - 3 1 2 4 3 Paratyphoid Fever - - - - - - - - - Acute Poliomyelitis 12 l 3 5 - 2 1 - - Dysentery 2 — — 2 — — — — Puerperal Pyrexia 42 - - - - 16 26 - - Erysipelas 4 - - — - - - - 4 Measles 938 5 352 565 11 l 4 - - Whooping Cough 20 3 8 8 - - 1 - - Malaria (contracted) abroad) - - - - - - - - - Food Poisoning 29 - 7 3 - 3 12 - 4 TOTALS 1077 10 373 593 17 33 46 4 11 Poliomyelitis During 1955, 12 confirmed cases of poliomyelitis were notified. The accompanying table shows the cases notified in previous years classified under age groups:- 41 42 POLIOMYELITIS INCIDENCE IN WANSTEAD AND WOODFORD, 1935—1955 Year Population No. Notified Notification Rate Jnder 1 1-5 5-10 Age Group 25-45 Over 45 Deaths Death Rate 10-15 15-25 1935 50010 2 0.039 - 2 - - - - - - - 1936 52010 2 0.038 - 1 1 - - - - - - 1937 53840 3 0.055 - 2 1 - - - - - - 1938 54810 2 0.036 2 1939 55880 - - - - - - - - - - - 1940 48620 - - - - - - - - - - - 1941 46640 1 0.021 - - 1 - - - - - - 1942 49850 - - - - - - - - - - - 1943 50010 - - - - - - - - - - - 1944 46670 - - - - - - - - - - - 1945 48230 4 0.082 - - 4 - - - - - - 1946 57570 1 0.017 - - - l - - - - - 1947 60280 10 0.165 2 - 1 l 2 4 - - - 1948 61150 1 0.016 - - - - 1 - - - - 1949 62010 9 0.144 - 1 - 4 3 1 - - - 1950 62460 14 0.224 - 5 2 3 3 1 - - - 1951 61850 - - - - - - - - - - - 1952 61880 8 0.129 - 1 1 4 - 2 - - - 1953 61540 13 0.211 - - 4 3 3 3 - - - 1954 61550 6 0.097 - - 3 1 - 1 1 - - 1955 61380 12 0.19 1 3 5 - 2 1 - - - Tuberculosis The following table shows particulars of new cases of tuberculosis and of deaths from the disease in the Borough during 1955:— Age Periods New Cases Deaths Pulmonary Non-Pulmonary Pulmonary Non-Pulmonary M F M F M F M F Under 1 year - 1 - - - - - - 1-5 years 1 - - - - - - - 5-10 years 1 - 1 1 — — - — 10-15 years — — 1 — — — - — 15-20 years 1 1 - 2 - — - - 20-25 years 2 - - - - - - - 25-35 years 4 3 1 3 - — - — 35-45 years 2 1 - - - - - - 4&-55 years — 2 1 1 - 1 - 1 55-65 years 4 — — — 2 — - — 65 and over 1 1 - - - - - - TOTALS 16 9 4 7 2 1 - 1 25 11 3 1 36 4 The 4 deaths represent a death rate of 0.05 per 1,000 of the population. A comparative summary over the past 20 years for the Borough is set out in the folkwing table:— 43 44 Year Nocitications Total Notification Rate Deaths Total Death Rate Pulmonary Non-Pulmonary Total Notifications Pulmonary Non-Pulmonary Total Deaths No. Rate No. Rate No. Rate No. Rate 1936 33 0.63 12 0.23 45 0.86 16 0.30 3 0.05 19 0.36 1937 37 0.68 10 0.18 47 0.87 26 0.48 5 0.09 31 0.57 1938 37 0.67 22 0.40 59 1.07 24 0.43 5 0.09 29 0.52 1939 28 0.50 9 0.16 37 0.66 22 0.39 3 0.05 25 0.44 1940 24 0.49 7 0.14 31 0.63 22 0.45 3 0.06 25 0.51 1941 46 0.98 15 0.32 61 1.30 16 0.34 — - 16 0.34 1942 42 0.84 21 0.42 63 1.26 33 0.66 4 0.08 37 0.74 1943 38 0.75 14 0.27 52 1.39 19 0.37 5 0.09 24 0.47 1944 43 0.92 13 0.27 56 1.19 16 0.34 4 0.08 20 0.43 1945 47 0.97 11 0.22 58 1.22 14 0.29 5 0.13 19 0.39 1946 50 0.86 7 0.12 57 0.99 28 0.48 4 0.06 32 0.55 1947 39 0.64 7 0.11 46 0.76 20 0.33 1 0.01 21 0.34 1948 38 0.62 5 0.08 43 0.71 16 0.26 3 0.04 19 0.34 1949 50 0.80 14 0.22 64 1.03 19 0.30 2 0.03 21 0.34 1950 41 0.65 4 0.06 45 0.72 14 0.22 1 0.02 15 0.24 1951 42 0.68 7 0.11 49 0.79 10 0.16 3 0.05 13 0.21 1952 47 0.76 4 0.06 51 0.82 10 0.16 — — 10 0.16 1953 48 0.78 4 0.06 52 0.84 3 0.05 2 0.03 5 0.08 1954 38 0.61 6 0.10 44 0.71 2 0.03 1 0.02 3 0.05 1955 25 0.42 11 0.17 36 0.59 3 0.03 1 0.02 4 0.05 Rates per 1,000 population. The register shows that at the end of the year:— 25(38) Pulmonary and 11(6) non-Pulmonary cases were notified for the first time during the year. 10(14) cases were transferred into the district. 1(no) cases were restored to the Register. 3(2) Pulmonary and 1(1) non-Pulmonary died during the year. 23(73) other cases were removed from the register. 476(456) cases remained on the Register at the close of the year. The figures in brackets are the comparable figures for the year 1954. SECTION G. PART III SERVICES. FOREST HEALTH AREA SUB-COMMITTEE Chairman: County Councillor Mrs. E. F. M. Hollis. Vice-Chairman: Councillor Mrs. L. M. Scott. Membership: Chingford Borough Council: Councillor W. J. Bowstead. Alderman Mrs. S. L. Oakes. Councillor Mrs. I. Titley Wanstead and Woodford Borough: Councillor Mrs. S. V. F. Ashton Councillor Mrs. I. C. Haseldon Councillor G. F. Hann Councillor J. Relph. Chigwell U.D.C: Councillor Mrs. V. L. M. Martin Councillor Mrs. L. M. Scott. Councillor Mrs. M. Smith. Epping U.D.C: Councillor Mrs. F. Pollitt Councillor A. G. Verrall. Waltham Holy Cross U.D.C: Councillor M. C. Barrett Councillor A. F. Flowers Epping R.D.C: Councillor Mrs. H. Howard. Harlow U.D.C: Councillor F. J. James, J.P. Hospital Management Committee: G. Gray, Esq. Executive Council for Essex: Alderman J. W. R. Nation. Local Medical Committee for Essex: Dr. H. Grylls. Essex County Council: Councillor Mrs. S. M. Bovill Councillor Mrs. D. D. Forster Alderman K. E. B. Glenny Councillor Mrs. E. F. M. Hollis Councillor F. J. Vaughan Councillor F. A. Wortley British Red Cross and St. John Mrs. J. Broome. Ambulance Organisations: Mrs. M. Tucker. Mr. G. F. Henrico Tuberculosis After-Care Association: Mrs. A. C. Murray. 45 STAFF In addition to my duties as Medical Officer of Health for the Borough, I am in administrative control of Part III Services under the National Health Service Act, 1946, sections 21, 22, £3, 24, 25, 26, 28 and 29. There are normally 2 medical officers of the Essex County Council working in the Borough and undertaking duties appertaining to Maternity and Child Welfare as well as 3 practitioners who regularly attend Child Welfare Clinics being employed on a sessional basis. HEALTH CENTRES (Section 21) Originally 6 sites were earmarked for the erection of Health Centres—all purpose, e.g. where General Practitioner and Local Authority services would be carried out in the same building. Experience has shown that there is little or no likelihood of these centres being built in the forseeable future and, indeed, their value, in a district such as this, might be of doubtful benefit to the Public who would probably prefer to continue attendance at their doctor's surgeries. As a result, 5 of the 6 sites have now been relinquished. The tendency to-day appears to be towards group practice in partnership rather than Health Centres, which are being built only on large Housing Estates and in New Towns. At the same time there is a definite need in the Borough for a modern Health Service Clinic where maternity, Child Welfare and other Local Authority services could be carried out. No such clinic at present exists, and we are obliged to work in various Church halls and adapted houses. A very suitable site adjacent to the present clinic building in High Road, South Woodford, was approved in principle, but, unfortunately, it was disposed of before negotiations for its acquisition could be commenced. CARE OF MOTHERS AND YOUNG CHILDREN (Section 22) There were 565 attendances at the ante-natal clinic in 118, Hermon Hill, this figure being almost identical with that of the previous year. At this clinic, sessions are held weekly, midwives examining their own patients and working in close co-operation with the general practitioners concerned. One general practitioner conducts an ante-natal clinic for his own patients at his surgery, with a Local Authority midwife in attendance. The scheme works well and achieves a maximum of co-operation between doctor and midwife. All expectant mothers have a blood specimen taken for examination and all with a rhesus negative result are advised to have their confinement in hospital. 46 Mothers booked for hospital confinement attend the ante-natal clinic for routine intermediate examinations. In the event of any abnormality becoming manifest, the case is referred at once to the Obstetrician at the Hospital. About 65 per cent of the births in the Borough take place in hospital. Discharges are notified promptly and are followed up by either the Midwife or Health Visitor depending on the day following delivery on which the discharge takes place. A very good liaison is maintained with the Maternity Department of Wanstead Hospital. Relaxation Exercises Relaxation classes have been continued at the Hermon Hill antenatal clinic, and are held twice weekly. Normally 6 to 8 women constitute a class. The classes also form a means whereby the Health Visitor can give short talks on preparation for the confinement and on various aspects of personal hygiene for mother and infant. By keeping classes small opportunity is afforded for individual queries and difficulties to receive attention. Vital Statistics Wanstead & England & Woodford Wales Live birth rate per 1,000 population 11.4 15 Still birth rate per 1,000 population 0.18 0.35 Infant Mortalitv Rate Der 1.(100 live births 17.3 24.9 Neo-natal mortality The neo-natal mortality is the number of infants dying under one month per 1,000 live births. During 1955, 9 infants died in the first four weeks of life, a rate of 12.9. Care of Premature Infants During 1955, 39 premature infants were born to residents in the Borough, 1 of these births takng place at home and 38 in hospital or nursing home. The one born at home was alive at the end of one month; 30 of the 38 born in hospital or private nursing home survived. In all cases of premature birth, special supervision is given after the 14th day or after discharge from hospital. 47 Child Welfare Centres Attendances at the six Child Welfare Centres has been well maintained. Although some of the Centres are conducted in old buildings, it can be said that the Borough is well catered for, as apart from the northern area with its more scattered population, generally there is a Centre within a mile radius of every home. Attendance figures were made up as follows:— Baptist Church, Hall, Aldersbrook 1534 Ashton Playing Fields, Woodford Bridge 2140 St. Barnabas Church Hall, Snakes Lane 3429 Fullers Road, South Woodford 3148 Cromwell Hall, Nightingale Lane, Wanstead 2456 Holy Trinity, Hermon Hill, South Woodford 3129 TOTAL 15,836 Welfare Foods The distribution of Welfare Foods continued on the lines indicated in my last report, being undertaken entirely by members of the Women's Voluntary Services. Foods are available at all the Child Welfare centres in the Borough during hours of session and also at the W.V.S. Headquarters, 79, High Street, Wanstead, Monday, Wednesday and Friday 10 a.m.—4 p.m. Day Nursery The average daily attendance at the Day Nursery, which has accommodation for 50 children, was 30.7, slightly up on 1954. My sincere thanks are due to the Women's Voluntary Services members for the great assistance they give by undertaking this service. The following table shows the attendances made, together with the daily average. Quarter Ending Attendances Under 1 year 1-2 years 2-3 years Over 3 years TOTAL Days Open Average Daily Attendances 31st March 38 298 397 1096 1829 65 28.1 30th June 32 327 306 901 1566 62 25.2 30th September 152 436 557 1116 2261 64 35.2 31st December 115 504 469 1151 2239 63 35.5 TOTAL 337 1565 1729 4264 7895 254 30.7 48 The nursery is an approved training school for the care of children under 5. During the year 3 students gained the certificates of the Royal Sanitary Institute. Nursery and Child Minders Regulation Act, 1948. Under this Act, any person who receives into her home for reward three or more children under the age of five years to be looked after for the day or a substantial part of the day, and premises, other than those wholly or mainly used as a private dwelling, are required to be registered with the Local Health Authority. At the end of the year the number of premises and child minders in the Borough registered with the County Council were:— Premises No. of Children Premises Nil Nil Child Minders 2 8 Daily Guardian Scheme The Daily Guardian Scheme, which was in operation prior to the introduction of the National Health Service Act, has been continued in the Borough, the purpose of the scheme being to augment, if necessary, the Day Nursery Service, or to provide accommodation where there is no day nursery in the district. The Daily Guardian is subsidised by the Local Health Authority in respect of children referred to her to the extent of 1/- for each full day attended, or 6d. per half day. During the year there were no Daily Guardians registered in the Borough, but this is to be expected inasmuch as there is a Day Nursery run by the Local Health Authority to serve the needs of the district. Womens' Welfare Clinics This clinic was held at 118 Hermon Hill monthly, with extra sessions as necessary. Contraceptive advice is given on medical grounds on receipt of a doctor's certificate. There were 179 attendances during the year. MIDWIFERY (Section 23) There are 3 domiciliary midwives practising in the Borough. Supervision is carried out by a nursing officer who is on the staff of the Area Medical Officer. 49 No. of confinements attended as midwife 108 No. of confinements attended as maternity nurse 61 i.e. doctor also present TOTAL 169 Gas and Air Analgesia A total of 141 patients in the district received gas and air analgesia. Training of Pupil Midwives During the year a request was received from the District Nurses' Home at Walthamstow for some temporary assistance to be given in the training of pupil midwives. As a result 6 pupils received training from one of our district midwives. HEALTH VISITING (Section 24) 5 Health Visitors were employed in the Borough during 1955. The Superintendent Health Visitor, Miss C. M. W. Court, A.R.R.C., S.R.N., S.C.M., H.V. Cert, reports as follows:— Throughout the year the general shortage of Health Visitors has been felt in Wanstead and Woodford. Additional duties have added to their case load, ie., B.C.G. Vaccination and Poliomyelitis Vaccination, so that visiting in the Borough has been selective. Requests from Hospitals to visit aged persons are numerous, to ascertain on discharge the need of home helps or domiciliary nursing. Health Education in the Borough is at present confined to Mothercraft Classes to expectant mothers combined with relaxation twice a week, and a few lectures on the Work of the Health Visitor have been given to the Townswomens Guilds. Under the new General Nursing Council Syllabus, lectures on the "Social Aspects of Disease" are now given by a Health Visitor to Nursing Students at Wanstead Hospital, which is followed by the students being given practical training in the Public Health Field entailing Home Visiting with a Health Visitor and attendance at Infant Welfare Centres and Case Conferences. Two Health Visitor Students from the South East Essex Technical College were allocated to Health Visitors, to correlate the practical and theoretical work of the Students. 50 The following table sets out statistically the work of the Health Visitors in the Borough during 1955:— Expectant Mothers (first visits) 138 Expectant Mothers (re-visits) 42 Infants under one year (first visits) 671 Infants under one year (re-visits) 1365 Infants 1 to 5 years (first visits) 87 Infants 1 to 5 years (re-visits) 1758 Stillbirth enquiries 9 Infant Death 11 Tuberculosis Patients 855 Aged and Infirm 60 Day Nursery Applications 5 School Children 274 Other Visits 351 Ineffective Calls 720 6346 HOME NURSING (Section 25) The Superintendent of District Nurses, Miss A. Williams, S.R.N., S.C.M., Q.I., Hv.Cert., reports as follows:— The staff employed on general nursing in the Borough consists of the equivalent of 6£ with the addition of the part-time services of two male nurses employed in the area. I am pleased to say that for the first time for a number of years there are sufficient staff to give a good nursing service in the Borough, and also to be able to devote more time to the care of the aged. The work in the Borough is very mixed, the type of patient consisting of the acute sick, chronic sick, patients requiring injections, and with a number of very heavy cases, particularly in the Woodford district. The male side of the general nursing work is undertaken by the two male nurses who are becoming very popular in the Borough. The staffing position is such that it has been possible this year to arrange the work more satisfactorily, thereby allowing the nurses to work more comfortably, and this has proved of benefit both to the nurses and the patients concerned. The following statistics show a comparison of the work undertaken by the District Nurses during the years 1954 and 1955:— 1955 1954 Number of New Cases 617 767 Number of Visits 19760 22184 Last Offices performed 35 33 Advisory or Casual Visits 471 496 51 VACCINATION AND IMMUNISATION (Section 26) Vaccination and immunisation is available at all Child Welfare Clinics, but in the majority of cases is carried out by the family doctor. Intensive propaganda, both personal on the part of clinic doctors and Health Visitors, and by means of leaflets and birthday cards, is maintained to ensure that all infants are immunised against Diphtheria. During the past 10 years the incidence of this disease has fallen to a minimum with the result that never having experienced it, present day parents tend to become complacent, and to postpone immunisation. Nevertheless it is estimated that 75—80 per cent of children are being protected. It is impossible to give an accurate figure as many practitioners do not trouble to claim the small fee available to them for recording the immunisation. Primary immunisation is usually carried out during the 6th—9th month, and a "booster" dose is given at 5 years, on entry to school. Immunisation against whooping cough is normally carried out from the 3rd to 6th month. The number of children who completed a full course of primary immunisation against diphtheria during the year is set out below:— Under 5 years of age 526 5 to 15 years of age 31 557 The number of children who received a secondary or re-inforcing injection was 227. The number of persons vaccinated or re-vaccinated during the year 1955 was:— Under 1 1—4 yrs 5—14 yrs. 15 or over Total Primary 346 40 35 44 465 Re-vaccination Nil 5 12 166 183 The following information shows the total number of children under 16 years of age who have at any time received a course of immunisation against diphtheria, as at 31st December, 1955:— Year of Birth Number Year of Birth Number 1955 357 1945 857 1954 207 1944 586 1953 610 1943 485 1952 510 1942 617 1951 476 1941 729 1950 525 1940 660 1949 645 1948 911 1947 919 Total 9,880 1946 786 52 Number of children immunised against Whooping Cough during the year 1955 was:— Under 6—12 1 year 2 years 3 years 4 years 5 years 6/12 months and over 15 117 18 6 5 5 9 PREVENTION OF ILLNESS, CARE, AND AFTER-CARE The work under this Section of the Act is mainly concerned with Tuberculosis and I am indebted to Dr. H. Duff Palmer, Physician to the Chest Clinic at Harts Hospital for the following report:— During 1955, 43 cases of tuberculosis were diagnosed. 141 new contacts attended for clinical and radiological examinations and 1 adult and 2 children were found to have pulmonary tuberculosis. The adult case is of some interest—a boy aged three, was admitted to Wanstead Hospital suffering from ? food poisoning. On investigation this was found to be Erythema Nodosum and a primary complex was also found in the chest. Examination of the contacts revealed the father to have pulmonary tuberculosis with a positive sputum and arrangements were made for him to be admitted to Harts Hospital. This case illustrates the value of the close liaison between the Hospital, Chest Clinic services and the Medical Officer of Health; also the necessity to investigate all contacts as soon as possible. General Practitioners are making more and more use of the services of the Clinic to investigate all types of chest disease. The total attendances amounted to 9608, a record number. 3,336 X-ray investigations were carried out. 44 children were vaccinated with B.C.G and it is hoped that parents will continue to take advantage of this very worthwhile method of prevention. Mr. F. C. Ware, Secretary of Leyton, Wanstead & Woodford T.B. Care Association reports as follows:— "The aim of the Association is to remove anxiety from the minds of tuberculosis patients by helping to solve some of the economic and domestic difficulties which may otherwise retard their recovery and to assist similarly those who are substantially and permanently handicapped by the disease. The assistance given is supplementary to grants from statutory bodies, and, after consideration of the applicant's financial circumstances may take the form of extra nourishment vouchers, payment of fares, financial grants for special needs, supply of bedding and clothing and other material help as agreed to by the Executive Committee. A review of the activities of the Association during 1955 reveals that this was a year of continued progress in both fund-raising and assistance to patients. As a result of raising more funds during the year than in any year previously the Association was able to authorise increased expenditure on assistance. 53 Once again the most successful activity was the Christmas Seals Campaign which established a new record for the Association. Total sales were £769 9. 11 and the net profit to the Association was £646 14. 5. The T.B. Helping Hand Association was formed in February of this year for the purpose of organising fund-raising activities for the Case Association. As a result of these activities, which included fashion shows, whist drives, and dances, a sum of £120 was donated to the Care Association by the end of the financial year. It is gratifying to report that much of the work for the T.B. Helping Hand Association and support of its activities emanates from Wanstead and Woodford. Further evidence of the sympathetic interest in our work from within the Borough was provided when we received a donation of £200 from the funds of the disbanded Woodford District Nursing Association to be used in assisting Wanstead and Woodford patients. In the following table will be seen the assistance given to patients during the financial year ended 31st March, 1956 Amount No. of patients Extra nourishment £1,257 94 Fares—relatives visiting and convalescence 93 22 Fares for patients attending Occupational Therapy Class 8 10 Learner Driver Course 7 1 Hire Purchase Debts 24 2 Art and Occupational Therapy materials 6 2 Wireless Licences 3 3 Christmas Grants 56 99 Dentures 4 1 Coal Bunker 5 1 Gas Bill 4 1 Removal Expenses 6 1 Financial 28 3 A T.B. Health Visitor on the staff of the Area Medical Officer works from the Chest Clinic. All notified cases of tuberculosis are visited at regular intervals, arrangements are made for the examination of contacts and patients are advised regarding measures to prevent spread of infection. Rehabilitation of Tuberculosis Patients During the year the Area Sub-Committee accepted financial responsibility in one case for a patient undergoing rehabilitation at Preston Hall Settlement. No charge is made to the patient. 54 Recuperative Holidays The Local Health Authority are empowered to provide recuperative holidays for persons not in need of medical or nursing attention and during the year 10 cases from the Borough have been sent away. The length of convalscence was:— One week 3 Two weeks 4 Three weeks Nil Four weeks 2 Five weeks 1 Domestic Help Service Miss Keay, Domestic Help Organiser reports as follows:— The year 1955 showed an increase of 30 per cent in applications for Domestic Help, the increase being absorbed mainly in help for the aged and maternity cases. The service continues to be administered as in previous years and all cases are visited as frequently as possible —a total of 884 visits being made throughout the year. Liaison with District Nurses, Health Visitors and Hospital Almoners is good, the aged and sick benefitting from the joint effort. There is still an acute shortage of Domestic Helps, despite efforts made to recruit through the Ministry of Labour, and advertising in the local newspapers. A total of 10 full-time and 45 part-time domestic helps is employed to attend to the varied wants of 160 patients. When an emergency call is received this does at times necessitate a Domestic Help being transferred to meet the greater need and her normal duties are left in abeyance. Every effort is made to attend people who are completely dependent on the service, for fires and meals. In connection with the latter the W.V.S. "Meals on Wheels" scheme, providing hot meals on Wednesdays and Fridays, has been of invaluable assistance. The Domestic Helps are to be congratulated on their unswerving efforts to comfort the sick and aged; many of them give freely of their own time over and above the duties asked of them by the service. During the year one Help attended a Training Course at Chelmsford and was successful in obtaining a certificate. A total of 4 helps have now attended this Course, and one and all have enjoyed it, and found it has broadened their outlook on the work and given them renewed vigour to carry out the tasks allotted to them. The requests for help for T.B. patients has continued low, and fortunately all requests were met. The aged chronic sick continue to grow in number, and are an increasing problem with the labour situation as acute as it is. Every effort is made, however, to keep the waiting period for help as short as possible, and to provide adequate help for the essential needs. 55 SCHOOL HEALTH SERVICES WANSTEAD & WOODFORD 1955 The number of children attending the fifteen maintained schools in the Borough was, at the end of the year, 6,942. 1. School Medical Inspections Under Section 48 of the Education Act, 1944, it is the responsibility of the Local Education Authority, to provide for the medical inspection at appropriate intervals of all the pupils in attendance at schools maintained by them and, in accordance with these regulations, 1,912 of the pupils in attendance at maintained schools in the Borough were examined by a School Medical Officer. The number of children inspected in each age group, were:— Routine Inspections No. examined No. referred No. referred for treatment for observation 1st age group (5—7 years) 698 106 85 2nd age group (10-11 years) 824 95 83 3rd age group( 14-16 years) 297 43 16 Special 'Inspections 93 20 27 2. Minor Ailment Clinics Fewer children attended at the minor ailment clinic which is held every Friday morning at the School Clinic at 93, High Road, E.18. 350 children made 431 attendances in 1955, compared with 490 children and 639 attendances in 1954. Particulars of the defects noted at these examinations are given in Appendix. 3. Cleanliness Surveys The School Nurses visited the primary and secondary modern schools soon after the commencement of each school term, to undertake the cleanliness survey of all pupils in attendance. 18,555 inspections were carried out. 44 individual children were found to be suffering from head infestation, but were satisfactorily cleansed by the parents following advice given by the School Nurse. 56 4. Diphtheria Immunisation The practice of asking Head Teachers to distribute propaganda leaflets to the parents of all new entrants to infant schools was continued. With each leaflet is a consent form which the parent is asked to complete and return to the Head Teacher if it is the wish that the child be immunised by a School Medical Officer. In many cases, the leaflet serves as a reminder to parents that the child should have a reinforcing injection and the general practitioner is asked to do it. 5. Short Term Convalescent Treatment During the year 16 pupils from schools in this Borough were sent for a recuperative holiday on the recommendation of a School Medical Officer. The children usually go to these homes for a period of four weeks but extensions of two weeks are agreed to if the Medical Officer at the home so recommends. 6. Dental Inspection and Treatment There was no change in the Dental staff at the clinic at 93, High Road, S. Woodford. A summary of the work carried out- at this clinic is shown at Appendix "A". 7. Child Guidance Service Children requiring child guidance are referred to the Child Guidance Clinic at High Street, E.17. Unfortunately there is a long waiting list but the more urgent cases are given priority and are seen with very little delay. 8. Specialist Services The provision of staff for the inspection and treatment of school children with ophthalmic and orthopaedic defects is the responsibility of the Regional Hospital Board. The ophthalmologist and physiotherapist visit the clinic at 93 High Road, E.18, each week, and, in addition a Visiting Orthopaedic Surgeon visits once a month to see selected cases and advise on their further treatment. Orthoptics, is another of the specialist services provided by the Regional Hospital Board, which is being used to a greater extent. The nearest orthoptic clinics are at Buckhurst Hill and Chingford and children from this Borough attend at either of these centres for treatment. 57 9. B.C.G. Vaccination of Schoolchildren In my report for last year I referred to the inauguration of this scheme, promoted by the Local Health Authority, offering B.C.G. vaccination to pupils of 13 years of age. This scheme commenced in this Borough in June, 1954, was continued throughout the year under review with the following results:— No. of children to whom offered 363 No. given skin test after parents consent received:— 273 (75.20 per cent.) No. vaccinated with B.C.G. 221 10. Anti-Tuberculosis Vaccine Clinical Trials I have previously referred to these investigations which the Medical Research Council began in this Borough in 1950, by seeking volunteers from among school leavers. Although all the volunteers have now left school and gone their different ways some with the forces, and others who have married and now have families of their own—contact is still kept with each volunteer and the Health Visitors have made visits to several hundred homes during the past year to obtain information as to the nature of their employment and record details of any illnesses since the date of their last examination. The Physician-in-charge of these trials has expressed his appreciation of the Work done on his behalf by the Health Visitors and his satisfaction with the high percentage of response shown by volunteers when called for their annual skin test and X-ray examination. The result of the investigations into the value of B.C.G. vaccine, are not expected to be known for a few years yet. 58 Defects found by medical examination of school children. The following table shows the defects found in school children as a result of examination by Medical Officers at the Clinic:— Defect No. found to require treatment No. to be kept under observation Skin 18 1 Eyes (a) Vision 26 2 (b) Squint 1 — (c) Other 5 — Ears (a) Hearing 3 — (b) Otitis Media — — (c) Other — — Nose or Throat 3 — Speech 15 — Cervical Glands — — Heart and Circulation — — Lungs 4 — Development (a) Hernia — — (b) Other — — Orthopaedic (a) Posture — - (b) Flat Foot 2 — (c) Other 3 — Nervous system (a) Epilepsy — — (b) Other 1 — Psychological (a) Development 4 — (b) Stability 3 — Other 29 — 59 APPENDIX "A" Dental Inspections and Treatment Number of pupils inspected (Periodic and Specials) 2337 Number found to require treatment:— (a) Periodic 883 (b) Specials 505 Total 1388 Number of individual pupils actually treated 844 Attendances made by pupils for treatment 3190 Fillings: Permanent teeth 2005 Temporary 441 Total 2446 No. of Teeth Filled: Permanent teeth 1878 Temporary 397 Total 2275 Extractions: Permanent teeth 69 Temporary 693 Total 762 Administration of anaesthetics: (a) Local 147 (b) General 309 Total - 456 Other Operations: (a) Permanent teeth 1162 (b) Temporary 413 Total 1575 60