II WANS 29 BOROUGH OF WANSTEAD & WOODFORD Annual Report of the MEDICAL OFFICER OF HEALTH FOR THE YEAR ENDING 31 ST DECEMBER 1964 PUBLIC HEALTH COMMITTEE Alderman G. C. E. Dixon (Chairman). Councillor G. E. Tovey (Vice-Chairman). Alderman R. A. Dalton. Alderman D. L. Forbes. Alderman V. E. Stevens. Councillor J. R. Charter. Councillor E. H. Downing. Councillor F. C. Mountier. Councillor C. A. F. Webster. STAFF OF THE PUBLIC HEALTH DEPARTMENT Medical Officer of Health: F. G. Brown, T.D., M.B., B.Ch., D.P.H. Deputy Medical Officer of Health: L.R.B.Parker, M.R.C.S., L.R.C.P., D.P.H., (part time) (resigned 17-3-6^+) D.J.Gordon-Smith, M.B., B.Ch., D.P.H., (part time) (appointed 20.4.64) Chief Public Health Inspector: M. G. Crook, (a) (b) (c) (d) (f) Deputy Chief Public Health Inspector: Smoke Control Officer J. T. S. Templeman, M.A.P.H.I. (a) (b) (g) Public Health Inspectors: A. J. Storer, (a) D. R. Chanin, K.A.P.H.I. (a) R. Swaby, M.A.P.H.I. (a) (b) (e) J. H. Loornan, M.A.P.H.I. (a) (b) (appointed 1.6.64). Clerks: Mrs. V. Birkett Mrs. E. Payton Mrs. M. E. Lush. (Part time). F. Barnes, (appointed 4.8.64). (a) Royal Society of Health and Public Health Inspectors' Examination Joint Board Certificate. (b) Royal Society of Health 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 Society of Health's Smoke Inspector's Certificate. (f) General Instructor's (Special) Certificate, Home Office Civil Defence School, Falfield, Glos. (g) City and Guilds full Technological Certificate Combustion Engineering Practice. WANSTEAD & WOODFORD BOROUGH COUNCIL TO THE MAYOR, ALDERMAN AND COUNCILLORS, BOROUGH OF WANSTEAD AND WOODFORD I have the honour to submit my twentieth and final Annual Report on the Health Services of the Borough for the year 1964. As the life of the Borough will be ending shortly it is necessary for me to produce this report several months earlier than is customary and before the Registrar General's statistics have been received. Consequently the report is smaller than usual and does not contain statistical tables. There have been no events of outstanding importance during 1964 and incidence of infectious disease has remained low. Preparations for the merger with the Borough of Ilford to form the London Borough of Redbridge have proceeded at officer level and are now well advanced. I have held the post of Medical Officer of Health for the Borough for close on twenty years, having taken up duties in September, 1945 and I have the distinction of being the first and only Medical Officer of Wanstead and Woodford employed full-time in the Public Health Service, my predecessor having been a general practitioner serving the Borough in a part-time capacity. Many changes have taken place over the years and I should like to take this opportunity of recording some of these, but, before doing so, I would mention one most serious health problem with which I was confronted in March 1947. Following one of the most severe winters on record and when we were suffering from the after-effects of war, flooding of the reservoirs at the Lea Bridge waterworks occurred. Owing to polluted water having entered the mains it was necessary for the main water supply to the Borough to be cut off for up to fourteen days. Warning notices were distributed to all houses in the Borough Within twenty-four hours. An emergency water supply delivered by tanks and lorries was brought into operation by the Metropolitan Water Board. Frequent visits were paid to schools, restaurants, cinemas etc., to ensure that the elementary principles of hygiene were being observed. Fortunately no serious disease was reported. In common with the whole of England and Wales poliomyelitis, a disease hitherto little known in this Country, struck the Borough in the Summer of 1947 and, thereafter to a greater or lesser extent, each year for the next twelve years. Now, thanks to immunisation the incidence of this disease is minimal. In my early days here the effect of diphtheria immunisation had not become manifest and a number of cases occurred. At present diphtheria is a rarity. Still more dramatic has been the decline in the incidence of Pulmonary Tuberculosis. This has been caused by the use of new drugs which have a -1- lethal affect on the Tubercle bacillus and which arrest the disease process. Whereas, formerly, there were lengthy waiting lists for admission to sanatoria and chest hospitals, these institutions are now being used for other purposes e.g. for cases of chronic Bronchitis and heart disease. The main hazards of life today are coronary thrombosis, lung cancer and mental illness. All of these show an increase and, in order to determine the causative factors further research is needed. The increasing number of old people in the community puts a strain on the Health Services. Turning to environmental health, slum clearance and the provision of clean air have made much progress. It can be said without fear of contradiction that we in Wanstead and Woodford have been pioneers in slum clearance. Energetic steps were taken to establish clearance areas and on these sites modern dwellings have now been erected. Similarly as regards clean air, a programme was approved consisting of eight zones and by October 1965 roughly three quarters of the Borough will be smokeless. All this has entailed considerable opposition from certain quarters and many hours of hard work have been expended. In conclusion I would say how much I have enjoyed ray work as Medical Officer of Health. It has been stimulating and varied. I have always had co-operation and help from Members of the Council and to them I extend my gratitude. My thanks are due to officers of the department both technical and clerical for their support. I have the Honour to be, Mr. Mayor, Ladies and Gentlemen, Your obedient Servant, FREDERICK G. BROWN, T.D., M.B., B.Ch., D.P.H. Medical Officer of Health. 8th March, 1965- -2- SECTION A GENERAL PROVISION OF HEALTH SERVICES 1. Public Health Officers of the Authority 2. Laboratory Facilities Pathological and bacteriological services are provided at the Pathological Laboratories, Wanstead Hospital, Wanstead, and Connaught Hospital, Walthamstow. The analysis of water, milk and food is carried out by Dr. J. H. Hamence and Mr. P. S. Hall, Public Analysts for the Borough, and by the Counties Public Health Laboratories. 3• Infant Welfare Centres There are seven 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. Madeira Grove Clinic, Snakes Lane, Woodford Green Wednesday, 2.30 - 4 p.m. St. Mary's Memorial Hall, South 'Woodford, E.18. Friday, 2.30 - 4 p.m. Cromwell Hall, Nightingale Lane, Wanstead, E.11 Thursday, 2.30 - 4 p.m. George Lane Baptist Church Hall "Wednesday, 2.30 - 4 p.m. All Saints' Church Hall, Woodford Green Monday, 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 - First, second and fourth Wednesday in each month. By appointment only. Orthopaedic - First Thursday afternoon in each month. By appointment to see Surgeon only. All day Tuesday, For after-treatment by appointment only. -3- Speech Therapy - Monday only during school term. By appointment only. - Wednesday only during school term at 118 Hermon Hill, Wanstead. By appointment only. Controlled by the North East Metropolitan Regional Hospital Board and delegated to the Forest Group Hospital Management Committee. 6. Chest Clinic Harts Hospital, Woodford Green. Sessions: Wednesday, 9.15 - 11 a.m. Alternate Thursdays, 4-6 p.m. By appointment only Fridays, 9*15 -11 a.m. B.C.G. Vaccinations - Saturday morning, ynce monthly. (by appointment only). Mondays, 9*15 - 11 a.m. - X-ray only. 7. Ambulance Facilities The service is administered centrally by the County Council; facilities are available locally through the depot at Ilford. 8. 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 1964. 9. Funeral Arrangements In two cases the Local Authority was required to make arrangements for the burial of persons during the year 1964. -4- SECTION B SANITARY CIRCUMSTANCES OF THE AREA REFUSE AND SALVAGE (a) Refuse Collection and Disposal The collection and disposal service operated satisfactorily during the year but the age and consequent condition of the vehicles gave rise to some difficulties because of mechanical breakdowns. Three new 50 cu. yard collection vehicles were purchased in September and three more are on order for delivery in April 1965. The 3 bulk transporter vehicles also now require replacement and arrangements are going forward for new vehicles to be purchased by the Greater London Council, the Authority which will be responsible for refuse disposal under London Government Re-organisation. Because of the impending re-organisation some difficulty was caused when the Cleansing Superintendent resigned in September, but by mutual assistance of the 3oroughs concerned supervision has been adequately maintained. (b) Salvage The collection of salvage continued satisfactorily during the year there being a small increase in the market price of paper in December. SEWERAGE AND SEWAGE DISPOSAL General Arrangements for sewerage and sewage disposal in the Borough continued to be reasonably adequate. There were no exceptionally heavy storms during the year and no serious flooding was experienced. (a) Main Drainage and Flood Relief Work is now in progress on main drainage scheme (I) Tavistock Road area, (II) South Woodford Station area and (III) George Lane and Gates Corner. The work is expected to be complete by 1966. The Consulting Engineers employed by the Council for main drainage and flood relief have completed details for scheme (IV) Monkhams Valley, the proposed stilling pond and screen at the head of the existing main surface water sewer being included. The scheme has been submitted to the Ministry of Housing and Local Government for approval. (b) Snakes Lane West The relaying of the soil and surface water sewers in Snakes Lane West has been completed and a surface water sewer has been laid in the northern -5- section of Charteris Road to serve part of the future comprehensive development area. (c) St. Barnabas Road Screening Chamber A detailed investigation of the present flow conditions existing at the screening chamber has revealed that the inverted siphon between the chamber and the eastern sewage disposal works is inadequate. A scheme for the rebuilding of the screening chamber and the enlargement of the siphon is now in course of preparation. Sewage Disposal (a) Eastern Sewage Works Due to the steadily rising sewage flow it is becoming increasingly difficult to maintain the high effluent standard required by the River Board. The rising flow can only be accommodated at peak periods by careful management and further capital works will probably be required if the standard is to be maintained in the future. The primary sludge digestion tanks have been cleaned and the removal of a large quantity of accumulated solids has considerably increased their efficiency. (b) Southern Sewage Works The second stage of the reconstruction and improvement scheme is well advanced and will be fully operational by March 1965. The works as reconstructed will be able to discharge an effluent well within the standard required by the River Board. SANITARY INSPECTION OF THE AREA The Chief Public Health Inspector reports as follows:Housing Act, 1957. Unfit Dwellings. In one case only was formal action taken to deal with property under Section 16 of the Act i.e., Time and Place notice with a view to closing it. This concerned a basement dwelling which was badly affected with dampness the owner of which raised an objection to its closure. A Closing Order was made under Section 18 (Power to make a Closing Order as to part of a building). Houses let in Multiple Occupation. Houses occupied in such a manner as to come within the meaning of the terms of the Housing Act 1961 were dealt with by informal action it being necessary in one case only to serve a formal notice to provide sinks and hot water. The Borough is not greatly troubled by this problem, those houses which are let in multiple occupation are well managed and let -6- generally to good type of tenants. There is no problem in so far as the coloured population is concerned. Rent Act, 1957. This Act which for some years was considered to be a dead letter in this Borough, was, near the end of the year suddenly brought into use again and in September one application was received and in December two. In each case an undertaking was given by the owner and in the first case the work required was executed and a certificate as to remedying the defects issued to the owner. One other Certificate of Disrepair that existed for several years was determined. Overcrowding. It was not necessary to report any case of overcrowding during the year. Removal Expenses. On only one occasion was it necessary to refund to the tenant the cost of removal from a house, which was the subject of a Closing Order, to a council property. Factories Act, 1937. There is nothing to report concerning local factories other than that contained in the tabulated details set out later. This is understandable, bearing in mind that the Borough is chiefly a residential one and the factories largely modern. Public Health Act, 1936 and 1961. Section 24, 1936 Act. Seven manhole frames and covers had to be replaced because of the broken condition of the existing covers. Contrary to previous years the Committee decided to recover the cost of providing the frames and covers and fixing them in position. Work was carried out by the manual staff of the Public Health Department. Tenders were called for and received in connection with the works of drainage re-construction involving 13 houses. The works in these cases were executed by private contractors and the cost recovered from the owners. Public Health Act 1961. Section 74 - Pigeons Nuisance. It was necessary during the year to continue from the previous year the destruction of pigeons. The collection of birds at the Broadway was -7- practically wiped out in 1963 some stragglers migrated to houses nearby in Kings Avenue. George Lane still had a good number but another gathering built itself up near The George, Wanstead. Our Contractor, Mr. Collier, did good work in reducing the numbers but it is necessary to keep up the effort being made so as to combat the nuisance. Rodent Control. Sewer Treatment. Treatment of the sewers continued as in previous years and again a servicing contractor was engaged for the work with good result. Surface Treatment. Our one operative coped with the surface infestations which continue to be of a minor nature, 385 complaints were dealt with and 414 treatments and re-inspections were carried out. Noise Abatement. Complaints through the year were few. One concerned the ringing of a hand bell by a rag and bone dealer which appeared to worry a night worker who being advised to sleep at the rear of the house insisted on doing so at the front. Although requested to do so he refused to take the action available to him. It can be imagined how difficult it is for the local authority inspectors to track down the offender who is continually moving in a motor lorry. Several complaints were dealt with concerning motor and motor-cycle repairs and all were dealt with by the Public Health Inspectors when visiting the offenders. The noise from a drum cleaning factory disturbed a resident although the noise was hardly discernable. It was difficult to find the source of the noise for some considerable time which proved to be that caused by a fan drawing off dust and rust from a shot cleaning machine. The trouble was obviated by fitting a baffle to the offenddne fan. Pet Animals Act, 1951. Six persons were licensed in 1964 to keep a pet shop. All were found in reasonable condition although some sell very few pets but keep the licence alive in case it is needed. In July the Public Health Committee adopted an unprecedented procedure in allowing a person outside local government service in tlie form of an inspector of the R.S.P.C.A. to report upon a Pet Shop where dogs are sold in large numbers. The proprietress of the premises was not permitted to attend the Committee to defend herself. -8- The Chief Public Health Inspector could see no good improvement coming from the R.S.P.C.A. inspector's suggestions. In consequence the Committee resolved:- (a) That the proprietress be asked to arrange as soon as possible for the premises to be cleared of all animals, sealed and fumigated for a period of three weeks, none of the animals to be brought back there after the rest period. (b) The Town Clerk be authorised to take proceedings if he has reasonable cause to believe that an offence has been committed at the kennels. The Town Clerk later reported that Counsel advised that a condition requiring two separate rest periods each year would be possible and enforceable but he did not think that the condition should forbid the return of stock previously at the premises. The licence subsequently issued contained a condition on the above lines and an additional condition in which no animal which has been present on the said premises for 12 hours or more during the seven days immediately preceding a rest period shall be brought back onto or kept on the said premises within seven days immediately following the conclusion of the same rest period provided always that this condition shall not apply in respect of any animal which has been examined by a qualified veterinary surgeon once during the seven days immediately preceding the commencement of a rest period and once during the seven days immediately preceding the termination of the same rest period and has been certified on both such occasions to be free from infection and/or contagious disease. Just how these conditions are going to prevent the death of some of the animals it is difficult to see bearing in mind that some hundreds are sold yearly and delivered to the kennels from all parts of the country. Animal Boarding Establishments Act 1963. An application for a licence to keep a boarding establishment was received from the proprietress of the above kennels but later withdrawn on the advice of her solicitor whose opinion was that proviso (a) in Section (5) of the Act excluded her business from the provisions of the Act. The Town Clerk advised that the solicitor's interpretation was not a correct one and although he (the Town Clerk) was of the opinion that an offence had been committed he would not advise taking proceedings. Rag, Flock and other Filling Materials Act 1951. There were no premises registered under this Act. Essex County Council Act, 1952. Section 103. One application was received for registration as Hawker of Foods under the Act. The number now registered is 18. -9- Petroleum (Consolidation) Act, 1928. The number of licences issued for the year was sixty-five. One new installation was established involving the storage of 1,500 gallons the spirit being for use in the firms lorries. Two installations had the storage capacity increased as follows: (1) 10,000 to 11,750 gallons, (2) 600 to 3,600 gallons, the latter being at the time of change of ownership. A car body repair firm increased the size of the cellulose store and one former licencee was threatened with prosecution for failing to render safe their disused underground tank. The taking of the necessary precaution prevented this action being taken. Eight tests were applied to tanks over 20 years old. None were found to be defective. Game Licences. Six licences to sell game were issued during the year. Wasps' Nests. As in previous years the eradication of wasps at a small charge was performed by the Rodent Operative. During the year 80 wasps' nests were destroyed. Children's Nightdresses Regulations Act, 1964. This Act came into operation on 1st October, 1964. No offences were observed and visits to shops showed that nightdresses not complying with the Act were not on sale. Fabrics (Misdescription) Regulations Act, 1959. It was not possible to purchase non-inflamable material. Shops Act, 1950. Only one offence was reported to the Committee and that concerned an infringement of Section 1 in respect of six days per week trading by an ironmonger. The Committee decided to take no action but asked for a further report in due course. No offences were observed in so far as closing times were concerned. 118 inspections were made during the year 1964. Essex County Council Act, 1953. Massage and Special Treatment Establishments. Ten visits were made to the premises concerned, all of which were reported to the Essex County Council as being in a satisfactory condition. -10- Consumers Protection Act, 1961. Eight visits were made and appliances tested. No infringements were observed. Swimming Bath Water. Six samples were obtained from swimming pools at schools and premises belonging to a national orphanage. All were suitable for swimming purposes. The Council in these enlightened days does not possess a swimming pool, local children having to go to surrounding local authorities for this facility. Inspections carried out by Public Health Inspectors. Infectious Disease enquiries 68 Visits in connection with contacts, disinfection, etc. 23 Enquiries in connection with food poisoning 12 Verminous Premises 18 General Environmental Public Health. Drains and Sewers inspected Drain tests applied 757 Public Conveniences and Urinals 8 Factories (mechanical) 59 Factories (non-mechanical) 20 Hairdressers' Premises 10 Schools and School Canteens 44 Overcrowding 7 Petrol Inspections 194 Shops Act Inspections 118 Outworkers' premises 41 Massage Establishments 10 Pet Animals Act 14 Fairgrounds 1 Swimming Baths 6 Smoke Observations 21 Cinemas, etc. 1 Rent Act 21 Heating Appliances (Fireguards) Act and Regulations 8 Licensing Act 15 Smoke Control Areas 4525 Offices, Shops & Railway Premises 64 Street Vendors, Hawkers, etc. 1 Miscellaneous 201 -11- SECTION C. HOUSING No. of dwellings erected during 1964 Council 45 Private Enterprise 237 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) 1478 (b) Number of inspections made for the purpose 1866 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 Nil (b) Number of inspections made for the purpose Nil (3) Number of dwelling-houses found to be in a state so dangerous or injurious to health as to be unfit for human habitation 7 (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 27 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 40 3. Action under Statutory Powers during the year:- (a) Proceedings under Section 9 and 10 of the Housing Act, 1957:- (1) Number of dwelling-houses in respect of which notices were served requiring repairs 23 (2) Number of dwelling-houses which were rendered fit after service of formal notices:- (a) By owners 16 (b) By Local Authority in default of owners Nil (b) Proceedings under Public Health Acts:- (1) Number of dwelling-houses in respect of which notices were served requiring defects to be remedied 161 -12- (2) Number of dwelling houses in which defects were remedied after service of informal notices:- (a) By owners 38 (b) By Local Authority in default of owners Nil (c) Proceedings under Section 16 and 18 of the Housing Act, 1957:- (1) Number of dwelling-houses in respect of which Demolition Orders were made Nil (2) Number of dwelling-houses demolished in pursuance of Demolition Orders 1 Notices served Public Health Act, 1936 Preliminary Statutory Section 93 78 - „ 24 - 60 „ 39 - 12 „ 45 - 2 „ 75 - 1 Public Health Act, 1961 Section 17 4 2 Housing Act, 1957 Section 9 17 23 FACTORIES ACT, 1937 1. Inspections for the purposes of provisions as to health (including Inspections made by Public Health 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 34 - - - (ii) Factories not included in (i) to which Section 7 applies 115 105 - - (iii) Other Premises under the Act (excluding outworkers' Premises) - - - - TOTAL 149 105 - - -13- 2. Defects Found Particulars Number of Defects Referred by H.M. Inspector Number of defects in respect of which Prosecutions were instituted Found Remedied Want of cleanliness 3 3 3 - Overcrowding - - - - Unreasonable temperature - - - - Inadequate ventilation 2 2 2 - Ineffective drainage of floors - - - - Sanitary conveniences: 1. Insufficient - - - - 2. Unsuitable or defective - - - - 3. Not separate for sexes - - - - Other offences 3 3 3 - TOTAL 8 8 8 - 3. Outwork Number of out-workers in August list required by Section 110(l)(c) Boxes 9 9 CLEAN AIR ACT Smoke Control Officer's Report. In the report for 1963 mention was made of memo 69/63 issued by the Ministry of Housing and Local Government in the latter part of that year, and of the Ministry of Power's comprehensive re-assessment of the probable availability of the different smokeless fuels. Briefly, as a result of the changes, the supply of gas coke - which in the past has been regarded as the basic solid smokeless fuel - would not increase; whilst supplies would be available for existing smoke control areas, the fitting of large numbers of coke burning open fires in future areas would create a shortage. To encourage the use of fuels other than open fire smokeless fuel, the Minister proposed widening the grant arrangements so that reasonable grants could be paid for room heaters (solid or gas), under-floor draught fires, electric storage heaters and suitable oil heaters. -14- It was intended that the amended grant arrangements should apply to those areas in which sufficient smokeless fuels for open grates would not be available and it was on this point that some confusion arose throughout the London area during the early part of 1964. Each authority proposing a new smoke control area had to approach the various fuel suppliers to ascertain the local situation, and v/hilst some replies were very optimistic others were shrouded in doubt. It was practically impossible to deduce whether a district was "hard coke" (room heaters) or "soft coke" (open fires). Fortunately the London and Home Counties Clean Air Advisory Council arranged a meeting with representatives of the Ministry of Power, Ministry of Housing and Local Government, Gas Boards, Distributors' Associations and local authorities. From the meeting emerged the fact that for the London area there would be sufficient open fire fuel available for:- a. All existing improved fires (whether burning coke or not) in proposed smokeless areas and b. All householders in such areas who, under conditions of individual freedom of choice, wished to install improved open fires. The important words in (b) "individual freedom of choice..." were interpreted as payment of reasonable grant for whatever appliance was selected, and not payment of grant based on the cheapest way of adapting the existing fireplace irrespective of the type of heating selected. In other words the system of grant payment, approved in 1963 by the Public Health Committee for S.C.A.5., on room heaters (solid or gas), electric fires, storage heaters and under-floor draught open fires was to continue in all proposed areas. It will be seen in tables given l iter in this report that in comparing the cost per application in areas Nos. 4 and 5 the increased grants have raised the cost of clean air, but not to the extent generally anticipated. The trend towards gas has continued and a large number of gas room heaters have been fitted. The gas image continues to ascend and despite being more expensive than solid fuel people are attracted by the efficiency of the appliances, absence of work and convenience of piped fuel supply. New methods of gas production would seem to promise stability of price and this in days of general price increases is an attraction in itself. Credit must also be given to the North Thanes Gas Board for its efficient canvassing in snoke control areas. Solid fuel room heaters have also proved popular. When operated correctly and, most important, with the complete removal of ash daily, these appliances give a very satisfactory performance at a reasonable cost. In addition to heating a particular room they quite often provide background heating for other parts of the house. -15- Solid fuel is the traditional fuel in this country. The organisations dealing with the various sections of the industry (fuel producers and distributors, appliance manufacturers and retailers) appear to operate with little cohesion. They have only recently realised the value of intensive canvassing in smoke control areas. With the increase in the use of gas as a fuel and the much wider range of solid smokeless fuels which can be used in room heaters, it is felt that the smokeless fuel supply situation will resolve itself. Apart from the Gas Boards, who will gradually reduce the production of solid smokeless fuel, other manufacturers, not least the National Coal Board, are forging ahead with plans for increased production find new types of open fire fuels. Therefore, for those who prefer the open fire the outlook is not so bleak and the smokeless brightly burning open fire, despite its inefficiency and draught production, will continue to be used for years to come. As last year, I have divided the work into three main groups a. Measurement of pollution b. Control of pollution - Smoke Control Areas and c. Other activities, such as conferences and exhibitions. (a) Measurement of pollution The department continued measurement of pollution as part of the National Survey by means of two daily volumetric instruments, one at Croft Lodge Close, Snakes Lane, Woodford Green, and the other at Oakhall Court, Wanstead. Both instruments are fitted with eight port valves which automatically change every twenty four hours, thus ensuring complete records over weekends and holiday periods. Details of average yearly figures since the instruments were installed are given below. The figures are expressed in micrograms per cubic metre. WOCDFCRD (CRCFT LODGE CLOSE). YEAR: Average for year: Average for Winter Months: Average for Summer Months: Highest daily recording: Smoke SO2 Smoke so2 Smoke so2 Smoke so2 1955 190 157 320 229 60 85 150 1086 1956 180 172 290 257 70 86 1120 1144 1957 170 172 310 266 50 60 2050 1973 1958 190 200 273 245 65 134 1080 1133 1959 130 172 190 283 43 71 1080 1856 1960 113 160 163 222 63 106 670 984 1961 98 124 178 195 44 77 720 652 1962 126 149 206 221 45 77 2392 2503 1963 87 118 144 171 29 65 603 864 1964 86 115 140 161 32 68 617 732 -16- WANSTEAD (OAKHALL COURT) YEAR: Average for year: Average for winter Months: Average for Summer Months: Highest daily recording: Smoke SO2 Smoke sO2 Smoke sO2 Smoke so2 1959 150 217 250 315 50 71 1200 1307 1960 115 163 178 229 51 97 1020 1410 1961 101 126 194 207 40 71 752 710 1962 111 147 179 222 42 72 1560 1619 1963 87 142 141 213 33 71 589 1268 1964 85 117 133 173 36 61 733 764 It will be noticed that there has been a slight decrease in pollution compared with last year, and this is likely to be the trend in the future. It is anticipated that the days of spectacular decreases in pollution are now past and steady improvement can only be obtained by continued concentration on the task. It is doubly important therefore at least to maintain and preferably to increase the impetus of smoke control, and encourage the neighbouring authorities to do likewise. (b) Smoke Control ,Areas The Order for the No.6 Smoke Control Area was made in June, 1964 and confirmed by the Minister on the 28th October. The date of operation is the 1st October, 1965. Details of the area are as follows:- Acres 335 Dwellings (including Council houses) 2630 Industrial premises 16 Commercial premises 90 Other premises 13 It was estimated that the cost of replacing and adapting existing fireplaces would be £45,185. 10. 0d. Five areas covering 12,310 premises and 2197 acres are in operation. -17- I give below details of applications received, grants approved and paid in the five areas plus the early applications in No.6 area. Applications for approval of works: Grants approved: Claims Received: Amount of Claims paid: Smoke Control Area No.1 438 £3,016.10.2 399 £2,614.3.2 Smoke Control Area No.2 853 £7,403.11.2 744 £6,880.19.0 Smoke Control Area No.3 1,014 £9,321.19.4 901 £8,324.11.9 Smoke Control Area No.4 785 £7,175.16.1 669 £5,997.1.9 Smoke Control Area No.5 1,810 £26,669.14.5 998 £15,072.1.0 Smoke Control Area No.6 36 £655.17.8 In 9 cases, 100 per cent grant was paid to persons in receipt of National assistance, and whose applications were supported by the Manager of the National Assistance Board. Some contraventions of a Smoke Control Order occur immediately after the Order comes into operation, but informal action normally ensures compliance. One persistent contravention in the No.4 Area was reported to the Public Health Committee who decided to take proceedings. The offender hurriedly packed his bags and vacated the premises leaving no trace of his whereabouts. Whether the knowledge of his misdemeanour weighed heavily upon him and was the principle cause of his departure is not known, but if so this must be the first recorded case of a refugee from smoke control seeking sanctuary in the smoke laden atmosphere over the border to the north or south of the borough. Estate agents are not by nature reticent in their description of properties advertised for sale; however one searches in vain for a desirable property "situate within a smoke control area". It is obvious that there is an urgent need for vastly more education on this subject to be carried out on a national scale. Vast sums of money are being spent to persuade people to give up cigarette smoking for their own good; it is a pity a similar sum is not spent on persuading people to stop choking their neighbours with smoke fumes from coal fires and disfiguring buildings and the countryside. -18- OTHER MATTERS Industrial Premises Nine notifications of intention to install new furnaces have been received during the year. Close liaison has been maintained with the Borough Engineer's department regarding the height of new chimneys for industrial boilers. Recommendations are based on the Memorandum on Chimney Heights issued by the Ministry of Housing and Local Government where appropriate. Conferences Two meetings of the Joint Conference of local authorities in South West Essex were held during the year, one at Barking and the other at Dagenham. Matters of general interest to the local authorities concerned were discussed. This authority continued to be represented on the following bodies:National Society for Clean Air. Standing Conference of Co-operating Bodies in the Investigation of Atmospheric Pollution (D.S.I.R.) London and Home Counties Clean Air Advisory Council. Exhibitions The mobile exhibition of the Solid Smokeless Fuel Federation was sited within smoke control area No.5 during one week in April and again in October. Once again considerable interest was shown and help given by the Federation representatives. -19- SECTION D FOOD AND DRUGS The Chief Public Health Inspector reports:Food and Drugs Act, 1955. The following matters were reported to the Public Health Committee together with the action taken. Complaints. (1) Piece of metal in apple tart. The Town Clerk advised no action because the purchaser/complainant would not attend court. (2) Ice lolly brought to the Public Health Department because child complained of a bitter taste. (3) Luncheon meat it was alleged was unfit but no action was taken on account of there being too many intervening circumstances between proof of sale and proof of unfitness. The meat when brought to the office was wrapped in dirty crumpled greaseproof paper and the place in which it was stored in the flat was far from satisfactory. (4) Can of garden peas containing beetle. Letter to the canners. (5) Loaf of bread with mould. Town Clerk instructed to take appropriate legal action if satisfied on legal considerations. (6) Pork and Egg pie with mould. Town Clerk instructed to take appropriate legal action. Although items such as are given at 5 and 6 are considered important it is surprising at the length of time it takes to get the cases taken before the magistrates. Referring to the case of the loaf of bread which was reported to the Public Health Committee on 9th September, 1964 and the pork and egg pie reported on 26th October, 1964, it is interesting to note that the cases were not taken to court until the 13th January, 1965 over four months in the former and two and a half months in the latter. (7) Nail in fish fillet. Town Clerk to take action if satisfied on the legal position. In this case too although it was reported to the Committee on the 1st December, 1964 no action had been taken when this report was drawn up two and a half months later. Meat and Food Inspection. The large wholesale meat warehouse continued to be inspected regularly and in this connection visits were also necessitated because of the regular' delivery of meat from a north east county port. -20- The following is a list of foods surrendered during the year 1964 because of the unsound condition:- MEAT, Fresh MEAT, Tinned Beef 748 lbs Corned Beef 501 lbs Boneless Beef Ham 468 lbs Trimmings 1650 lbs Jellied Veal 122 lbs Ox Tongues 38 lbs Pork 42 lbs Ox Kidneys 413 lbs Pork Luncheon Meat 859 lbs Pigs Kidneys 14 lbs Ox Tongues 38 lbs Lambs Livers 155 lbs Stewed Steak 112 lbs Bacon 97 lbs Miscellaneous Tinned Pigs Spleen 2k9 lbs Foods 6869 tins Chickens 573 lbs Rabbits 40 lbs Frozen Foods 731 packets List of foods sampled is given below:- Apples 3 Aspirins 1 Bacon 1 Banana Yoghourt 1 Beef Mince Roll 1 Beef Suet (shredded) 1 Bicarbonate of Soda 1 Blackcurrant Drink 1 Blackcurrant and Glycerine tablets 1 Blackcurrant flavoured pastilles 1 Brisket 1 Butter 5 Cherry Cough pastilles 1 Cheese 2 Cheese (grated) 2 Cocktail Cherries 1 Cocktail Onions 1 Cod Liver Oil 1 Coffee 4 Corn Oil 2 Cream 1 Curry Powder 1 Custard Powder 1 Demerara Sugar 1 Egg and Veal 1 Flour, plain 1 Gees Lintus pastilles 2 Glycerine, Lemon & Honey pastilles 2 Grapes 1 Ground Almonds 2 Ground Cinnamon 1 Ground Nutmeg 2 Ground Rice 2 Haddock Fillets 1 Ham 2 -21- Hamburger & Beef 1 Herrings in Lemon 1 Honey 1 Horseradish 3 Jelly 3 Lard 1 Lemons 1 Luncheon Sausage 1 Malt Vinegar 1 Margarine 1 Milk 1 Minced Beef 1 Minced Turkey 1 Mint Sauce 1 Mixed Peel 3 Peas (garden) 1 Prawn Curry 1 Pressed Beef 1 Salad Cream 1 Sausages (pork) 5 Sausages (beef) 1 Semolina 1 Sultanas 1 Sweet Piccalilli 1 Strawberry Jam 2 Tea 3 Tomato Concentrate 1 Tomato Ketchup 1 Tomato Pickle 1 Veal, Ham and Egg Pie 1 96 The Milk (Special Designation) Regulations, 1960. Fifteen samples of milk were taken all of which were reported as satisfactory. Manufacture, Storage and Sale of Ice Cream. Two applications for premises to be registered for the storage and sale of ice cream were received and considered by the Public Health Committee. Both were granted. Changes of ownership were made in respect of five premises and the ice cream licences were transferred accordingly, and one application was received concerning the cooking of Ham. Ice Cream (Bacteriological Examination) Five samples of ice cream were obtained and the results were as follows. Ministry of Health's Provisional Grading Grade Grade Grade Grade Taken I II III IV Nos. 5 5 - - Per cent 100 - - -22- Food and Drugs and Bacteriological Examinations As in former years, the Food and Drugs samples were submitted to Messrs. Bernard Dyer and Partners Ltd. (Dr. J. Hp Hamence, F.R.I.C., and P. S. Hall, Esq., F.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.R.I.C., F.R.S.H., Gordon Miles, Esq., B.Sc., F.R.I.C., F.R.S.H., R. F. Rackham, Esq., B.Sc., M.R.S.H., & E. English, Esq., B.Pharm., B.Sc., F.R.I.C.,) of Thresh House, Verulam Street, Gray's Inn Road, W.C.1. The Department is appreciative of the help given by these two laboratories during the year. Food Hygiene (General) Regulations 1960. In July the Metropolitan Police reported finding a driver of a van in which ice cream was sold was smoking and the floor of which was covered with cigarette ash. The vehicle contained uncovered wafers and cornets. The Town Clerk gave as his opinion that the driver was not handling food at the time of the incident nor was he in a food room. Section 103 of the Essex County Council Act, 1952 says that "No person shall sell or offer or expose for sale any food from or upon a vehicle etc., unless he is registered by the local authority". The vehicle and driver were there to sell ice cream but no action was taken because the evidence disclosed no offence as there was no sale or offer or exposure for sale at the time. The food premises in the District may be classified as follows Confectioners (cakes, pastries) 31 Grocers 80 Greengrocers 37 Butchers 33 Confectioners and Tobacconists 67 Restaurants and cafes 41 Fishmongers 15 Dairies and Milkshops 10 Miscellaneous 65 of these 133 are registered for the storage and sale of ice cream; 61 are registered for the preparation of preserved foods. Disposal of unsound foodstuffs The unsound food condemned by the Public Health Inspectors is destroyed in the incinerator at Chingford. -23- Inspection of Food Premises and Vehicles Butchers' Shops, Stalls, etc. 118 Wholesale Butchers' Depots 103 Fish Fryers 12 Hotels, Boarding Houses, Etc. 4 Bakehouses 53 Fishmongers 29 Grocers 156 Restaurants and Cafes 107 Dairies and Milkshops 15 Greengrocers 82 Ice Cream Premises 41 Street Vendors 4 Food and Drugs Sampling 77 Ice Cream Sampling 5 Milk Sampling 15 Other Premises 90 Food Hygiene Regulations 82 -24- SECTION E PREVALENCE OF, AND CONTROL OVER, INFECTIOUS AND OTHER DISEASES The following table shows the incidence of infectious disease during the year, together with the number and percentages of cases admitted to hospital and the number and percentage of deaths. Disease Total Notified 1 Removed to Hospital Per cent Removed to Hospital Deaths Deaths per cent of cases Notified Smallpox - - - - - Scarlet Fever 2 - - - - Diphtheria - - - - - Pneumonia 3 - - - - Cerebro-Spinal Fever - - - - - Acute Poliomyelitis - - - - - Acute Polioencephalitis - - - - - Encephalitis Lethargica - - - - - Dysentry 7 1 14.2 - - Puerperal Pyrexia 11 11* 100 - - Paratyphoid Fever - - - - - Enteric or Typhoid Fever - - - - - Meningococcal Infection - - - - - Erysipelas 7 - - - - Measles 210 - - - - Whooping Cough 44 1 4.5 - - Ophthalmia Neonatorum - - - - - Food Poisoning 4 2 50 - - * These cases all occurred in hospital -25- These cases of infectious disease have been divided into age incidence and set out in the accompanying table:- Disease All Ages Under 1 yr. 1-4 yrs. 5-9 yrs. 10-14 yrs. 15-24 yrs. 25-44 yrs. 45-64 yrs. 65 & Over Scarlet Fever 2 - 1 1 - - - - - Pneumonia 3 - - - 1 - - 2 - Typhoid Fever - - - - - - - - - Dysentery 7 - 1 1 1 1 3 - - Acute Poliomyelitis - - - - — — — - - Puerperal Pyrexia 11 - - - - 5 6 - — Erysipelas 7 - - - - 1 - 5 1 Measles 210 12 113 81 2 2 - - - Whooping Cough 44 10 15 18 - — 1 - - Ophthalmia Neonatorum - - - - - - - - - Meningococcal Infection - - - - - - - - - Food Poisoning 4 - 2 - 1 - 1 - - TOTALS 288 22 132 101 5 9 11 7 1 Poliomyelitis During 1964 no confirmed cases of poliomyelitis were notified. -26- Tuberculosis The following table shows particulars of new cases of tuberculosis and of deaths from the disease in the Borough during 1964. Age Periods New Cases Deaths Pulmonary Non-Pulmonary Pulmonary Non-Pulmonary M F M F M F M F Under 1 year - - - - - - - - 1-5 years - - - - - - - - 5-10 years - - - - - - - - 10-15 years - - - - - - - - 15-20 years 2 - - - - - - - 20-25 years 1 - - 1 - - - - 25-35 years 2 - - - - - - - 35-45 years - - - - 1 - - - 45-55 years 1 - 1 - - - - - 55-65 years 2 - - - - - - - 65 and over - - - - - - - - TOTALS 8 - 1 1 1 - - - 8 2 1 - 10 1 -27- SECTION F. PAST III SERVICES "OREST HEALTH AREA SUB-COMMITTEE Membership 1964/65 Nominated by:- Name Chingford Borough Council Councillor Mrs. C.M. Game Councillor S.J. Silk Councillor Mrs. D.M.E. Linfoot Wanstead and Woodford Borough Alderman Mrs. E.F.M. HoDlis, M.B.E. Council Councillor Mrs. I.E.C. Haselden Councillor Mrs. M.J. Thorp Councillor J.A. Vane Chigwell Urban District Council Councillor Miss M. Brant Councillor M.F. Cowen Councillor W.S. North Councillor E.G. Perry Epping Urban District Council Councillor N.G. Barber Waltham Holy Cross Urban District Councillor E.J. Clarke Council Epping and Ongar Rural District Councillor D.O. Moss Council Appropriate Hospital Management Mrs. A.J. Morris Committees Executive Council for Essex Mr. J.W.R. Nation Local Medical Committee for Essex Dr. H. Grylls Essex County Council + Alderman K.E.B. Glenny Alderman A.E. Brown + Councillor Mrs. S.M. Bovill (E) Councillor W.J. Bowstead Councillor Mrs. A.E. Welsh Councillor Mrs. V.L. Wilson Councillor F.A. Wortley + ex-officio members (E) Members nominated by Education Committee Voluntary Organisations Mrs. Vernon Walker Mrs. L.M. Scott Mr. G.M. Williams One vacancy -28- HEALTH SERVICES CLINICS I mentioned in my last report that plans were in hand for the Health Committee to take over a former County Primary School in order to relinquish one of the halls hired for health service purposes and on the 1st July, Madeira Grove Clinic was opened, talcing over the Child Welfare Clinic formerly held in the St. Barnabas Hall, and facilities for the provision of Relaxation Classes and Chiropody and a permanent base for the Health Visitors working in that part of the Borough. CHILD WELFARE CLINICS Attendances at the Child Welfare Clinics during 1964 numbered - 18,205. NURSERIES 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. The number of premises and child minders in the Borough registered with the County Council is: Premises No. of Children Premises 10 308 Child Minders 7 61 WOMEN'S WELFARE CLINIC Owing to the decreasing number of patients attending the session held at 118 Hermon Hill during the year it was decided to terminate the session on the 31st December. Patients are now referred to the Family Planning Clinic. WELFARE FOODS. The distribution of Welfare Foods continued on the lines indicated in my previous reports, being undertaken entirely by members of the Women's Voluntary Service. Foods are available at all the Child Welfare Centres in the Borough during hours of sessions and also at the W.V.S. Headquarters, 2, Grove Park, Wanstead. My sincere thanks are due to the Women's Voluntary Service members for the great assistance they give by undertaking this service. -29- CASE OF PREMATURE INFANTS During 1964 53 premature infants were born to residents in the Borough, 5 of these births taking place at home and 48 in hospital or nursing home. 4 of the children born at home were alive at the end of one month. Of the 48 born in hospital or nursing home, 38 survived. MIDWIFERY Miss A. Williams, S.R.N., S.C.M., Q.I., H.V.Cert., Non-Medical Supervisor of Midwives, reports as follows:- Four midwives undertook the midwifery in the Borough of Wanstead and Woodford until December when Mrs. Powis transferred from the midwifery service to Health Visiting at Chingford. Miss Turner resigned on the 9th January, 1964, but after six months rest returned to undertake part-time midwifery duties, which entails visiting 48-hour hospital discharges. Two new midwives were appointed to the Borough - Mrs. S. Trundley on the 23rd March, 1964 and Miss C. McGrath on the 20th April, 1964. Three Part II Pupil Midwives completed their training during the year, with good results. 253 confinements were attended 144 patients received Gas and Air analgesia 75 patients received Trilene analgesia 172 patients received Pethedine or Pethelorfan ANTE-NATAL CLINICS There were 1,008 attendances at the Ante-Natal Clinic, 118 Hermon Hill, E.18. The sessions are held weekly and all the Midwives are in attendance, working in close co-operation with the patient's own doctor. RELAXATION CLASSES Two sessions a week are held in the Clinic at 118 Hermon Hill, and one at the Madeira Grove Clinic, the numbers attending being kept small to enable individual attention to be given. These, classes are very popular with the general medical practitioners and patients alike. HEALTH VISITING (Section 24) The Superintendent Health Visitor, Miss C.M.W. Court, A.R.R.C., S.N.R., C.M.B., H.V. Cert., reports as follows:- We have five Health Visitors in the Borough. One left in August for maternity reasons and we have not been able to replace her owing to the current shortage of Health Visitors. -30- The Health Visitors have close liaison with Claybury Hospital. Meetings are held once a month with Dr. Schoenberg and Health Visitors attend Ward Discussions with the residents and patients twice each week. We have acquired Madeira Grove Primary School which has been converted into a Clinic, and Infant Welfare Clinics are held on the premises each Wednesday afternoon instead of at the St. Barnabas Church Hall. Relaxation and Mothercraft Classes are also held at Madeira Grove and a flourishing Mother's Group is now in existence. Four Health Visitors from the Borough attended an In-service Course in Psychiatric Training at Goodmayes Hospital in May. The practice of Student Nurses from Wanstead Hospital being given practical training in the public health field has continued and one student Health Visitor sponsored by the Essex County Council under its training scheme commenced her practical training in this Area during the latter part of the year. HOME NURSING (Section 25) The Superintendent of District Nurses, Miss A. Williams, S.R.N., S.C.M., Q.I., H.V.Cert., reports as follows:- Good nursing care has been given to the patients in the Borough during the year 1964 by six district nurses and one male nurse. A good proportion of the nurses' work is caring for the elderly sick and chronic patients, and blanket bathing the aged. Again, good co-operation has been maintained with Langthorne Hospital for the care of patients on a six weeks in and out of hospital basis. This arrangement is a great help to the patients' relations and the staff. A number of Student Nurses from Wanstead Hospital have again been taken into the homes of the patients to see the work of the District Nurse. Number of new cases 694 Number of visits 19,093 VACCINATION AND IMMUNISATION Intensive propaganda both in the form of leaflets and birthday cards as well as by the personal approach from the Health Visitors and the Medical Officers attending the Child Welfare Clinics, is maintained to ensure that all infants are immunised and in order to maintain the vaccinal state of the public. -31- The following statistical information is supplied on the programme carried out during the year:- POLIOMYELITIS Oral Vaccine Primary Course 723 3rd dose 9 4th dose 367 Salk Vaccine Primary Course 160 3rd injection 68 4th injection DIPHTKERIA/TETANUS/WHOOPING COUGH Primary Courses: Under 5 years of age 777 5-15 years of age 8 Re-inforcing injections 295 DIPHTHERIA/TETANUS Primary Courses: Under 5 years of age 7 5-15 years of age 10 Re-inforcing injections 55 DIPHTHERIA Primary Courses: Under 5 years of age 13 5-15 years of age 5 Re-inforcing injections 95 TETANUS Primary Courses: Under 5 years of age 12 5-15 years of age 104 Over 15 years of age 67 WHOOPING COUGH Primary Courses: Under 5 years of age 17 Re-inforcing injections 1 -32- VACCINATION AGAINST smallpox The number of persons vaccinated or re-vaccinated was:- Under 1 1-4 years 5-14 years 15 or over Total Primary 237 982 87 246 1,552 Re-vaccinations - 2 22 293 317 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 23 cases from the Borough have been sent away. CHIROPODY The County Council's chiropody service has continued to provide treatment for cases from the whole of the Borough, in addition to the service provided by the Old People's Welfare Association for people residing in the Woodford Bridge district. Whilst the service is adequate for those who are able to attend the three clinics at which sessions are held, little can be done to provide a domiciliary service; as many as possible of these cases are conveyed to the clinic by transport, either by ambulance or by voluntary workers. DOMESTIC HELP SERVICE The Domestic Help Service has throughout the year continued to meet all applications requesting Domestic Assistance for the essential needs of the aged, the chronic and acute sick, confinements and homes where, for various reasons, the mother is absent for a temporary period. The following patients were receiving service at the close of the year: Aged 378 Maternity 9 Chronic sick 60 Acute Sick 4 Harassed Mother 2 Mental disability 2 The loyal service of the staff of 98 Home Helps covering many varied and often difficult duties has been maintained and has enabled a proportion of elderly patients and younger patients suffering with permanent disabilities to remain happily in their own homes with the confidence that the routine cleaning, shopping and needs of the home would be reasonably maintained. The standard of service has only been made possible by the quality of the individual service given by each Home Help. -33- The assistance of the W.V.S. in arranging Meals on Wheels for four days a week to homes where the effort of cooking has been too great has, yet again, been of very real value, as also the immediate response to the request for bedding or clothing when needed. The glad response of the W.V.S. has always made the task of meeting any need of patients in this way a privilege of the service to occasionally arrange. SCHOOL HEALTH SERVICES 1964 WANSTEAD AND WOODFORD 1. School Medical Inspections There was no change in the arrangements for the periodic examination of pupils attending maintained schools, the details being as follows:- 1. As entrants (5-6 years) 571 2. After admission to Secondary Schools (11-12 years) 440 3- 14-15 year age group 568 4. Others 14 5. Specials (at request of Head Teacher, Teacher, Parent, School Nurse, etc.) 4 6. Re-examination (i.e. follow-up of a defect previously noted) 422 TOTAL (all groups) 2019 2. Cleanliness Surveys 1016 pupils were inspected of whom only 1 was found to have some head infestation. This was cleared by the parent upon following instructions issued by the School Nurse. 3. B.C.G. Vaccination of School Children There was a very slight fall in the acceptance rate which was 72.3% in 1964 (72.6 in 1963). B.C.G. Vaccination was offered to 716 pupils of 13 years of age, acceptance being 543. There were no significant findings amongst the positive re-actors. 4. Tuberculosis Case Finding amongst School Entrants Parents continue to give a satisfactory response to this scheme which involves a skin test on a child shortly after school entry. 654 children were eligible of whom 489 were tested. A positive re-action was noted in 8 cases and the follow-up contact tracing of one of the cases resulted in an elderly man, a lodger in the -34- house, being found to be sputum positive and to have a large tuberculous cavity in one lung; hospital treatment was provided. 5. Child Guidance Service During the latter part of 1964, arrangements were made for the Educational Psychologist from Ilford Child Guidance Clinic to be responsible for testing children attending schools in Wanstead and Woodford; this step was taken in preparation for the transfer' of functions under London Government Re-Organisation. The Child Guidance Clinic at Walthamstow remained the centre for children considered in need of psychiatric treatment. 6. Defective Hearing Hearing tests continued to be made on pupils suspected by Head Teachers or School Medical Officers to have some loss of hearing, but in no case was any defect of significance discovered. 7. School Clinic A School Medical Officer continued to attend each Friday morning at 93, High Road, South Woodford, when special cases were seen for a variety of reasons, e.g. referral to Child Guidance Clinics, Hearing Tests, examinations for employment, etc. 8. School Dental Service Whole time service continued to be provided at the Clinic at 93, High Road, South Woodford, a summary of the work carried out is given at Appendix 'A'. 9- Speech Therapy The Speech Therapist attends at 93 High Road, South Woodford on Mondays and at 118, Hermon Hill, South Woodford, on Wednesdays. During the year a total of 144 sessions were held in which 72 pupils made a total of 688 attendances. A cure was effected in 19 cases; those under treatment at the end of the year numbering 36, the remaining 17 cases having failed to continue to attend for treatment. 10. Specialist Services The Clinic at 93, High Road, South Woodford, continues to be used by arrangement with Essex County Council, for the provision of Ophthalmic, Orthoptic, Orthopaedic and Physiotherapy services under the auspices of the North East Metropolitan Regional Hospital Board. -35- APPENDIX "A" Dental Inspections and Treatment: Number of pupils inspected (periodic and specials) 2,832 Number found to require treatment 1,543 Attendances made by pupils for treatment 2,008 Fillings: Permanent Teeth 1,636 Temporary 413 2,049 No. of Teeth Filled: Permanent Teeth 1,485 Temporary 346 1,831 Extractions: Permanent Teeth 4 Temporary 234 238 Administration of anaesthetics: 66 Other Operations 237 -36-