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Total under 1 year Asphyxia from Vomit - - 1 1 - 2 Atolectasis 3 - - - - 3 Bronchitis - 1 - - - 1 Broncho-Pneumonia 2 3 1 - - 6 Congenital Malformation 4 2 - - 1 7 Erythroblastosis Footalis 2 - - - - 2 Haomolytic Disease of new born 1 - - - - 1 Miliary Tuberculosis - - 1 - - 1 Prematurity 9 1 - - - 10 Totals 21 7 3 1 1 33 NEO-NATAL MORTALITY - 1949. Cause of Death.
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Age at Death Under 1 week 1-2 weeks 2-3 weeks 3-4 weeks Total Atelectasis 3 - - - 3 Broncho-Pneumonia 1 - - 1 2 Congenital Malformations 2 1 1 - 4 Erythroblastosis Footalis 2 - - - 2 Haemolytic Disease of Now Born 1 - - - 1 Promaturity 8 - 1 - 9 Totals 17 1 2 1 21 - 5 - GENERAL PROVISION OF HEALTH SERVICES IN THE AREA. HEALTH CENTRES. During the year further progress was made with regard to earmarking sites for Health Centres. Recommendations have been made for five sites to bo reserved for Centres which will servo the five neighbourhood units into which the town is at present divided.
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In making these recommendations it was envisaged that the site chosen in the natural centre of the town, adjacent to existing hospital facilities, would bo for the major health centre of the town. During the year the five dental centres in the area operated as Health Centres, but the general dental service for which they were so designated Health Centres was reduced to a minimum, because of the shortage of dental officers and the need for ensuring adequate cover for the priority services. DAY NURSERIES, The great demand for Nursery places continued and throughout the year the average number of children awaiting admission was 411, whereas the total number of places available was 168. Every effort was made to forward the schemes for converting the former Castle School into a day nursery, and for erecting new premises on a site in St.Ann's Road. It is expected that the conversion of Castle School, which will provide 66 places, will be completed during 1950.
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With regard to Eastbury Day Nursery, which is accommodated in property belonging to the National Trust, the Trustees gave notice that the present tenancy of the premises for occupation as a Day Nursery would expire in May,1952. This Nursery provides 80 places and is at present the only nursery in the Western half of the town. DOMESTIC HELPS. Domestic Helps were mainly allocated to chronic sickness cases and to the aged. There was,however, an increased allocation to tubercular patients. There is need for the employment of male domestic helps to meet the needs of male chronic sick patients and aged men, particularly those living alone. - 6 - HEALTH VISITING. The following table shows the number of visits paid by Health Visitors during the years- Expectant Mothers Children under 1 year of age. Children between the ages of 1 and 3. Other Cases First Visit Total Visits First Vis its Total Visits First Vis its Total Visits.
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First Visit Total Visits 991 1342 1348 6463 Nil 7229 1692 2193 HOME NURSING, The home nursing facilities were adequate. During the year the District Nurses Home at 144/146 Longbridge Road opened, and has facilitated the nursing of cases in the Western half of the town. Male home nurses operated from this Home. INFANT WELFARE. It is estimated that of the children born during the year, over 90% attended infant welfare clinics. MIDWIFERY. The arrangements for domiciliary midwifery wore adequate. Close liaison between the Barking Maternity Hospital and the Ante-Natal Service was maintained, and the Medical Officers of that Hospital continued to undertake a significant number of ante-natal sessions in combined treatment centres. POST-NATAL CLINIC. The steady increase in the number of women attending the post-natal clinic was maintained, and during the year 1,101 cases attended.
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TOTAL CLINIC ATTENDANCES. The total attendances made to all clinics during the year was 170,206. - 7 - CHIROPODY. The popularity of this service was maintained and the following figures show the number of attendances made during the years- School Children 1,215 M.&.C.W. patients 78 Public Adult Scheme patients 21,455 IMMUNISATION, Diphtheria. The following table shows a comparison of the total immunised child population in 1949 as compared with 1948:- Age Group. 1948. 1949. 0-5 years 56.2% 57.2% 5-15 ,, 81.8% 83% 0-15 ,, 71.5% 73% During the year 2 cases of diphtheria occurred- both were non-immunised children and unfortunately one died. Whooping Cough.
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The demand for whooping cough immunisation continued and 1062 children were inoculated. A total of 225 children were notified during the year as suffering from whooping cough, but no deaths from this disease were recorded. - 8 - 9 DIPHTHERIA IMMUNISATION IN RELATION TO CHILD POPULATION. Number of children at 31st December,1949, who had completed a course Of Immunisation at any time before that date (i.e., at any time since 1st January,1945. Age at 31.12.49. Under 1Yr. 1 Yr. 2 Yrs. 3 Yrs. 4 Yrs. 5-9 Yrs. 10-15 Yrs. Total i.e.
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born in Year 1949 1948 1947 1946 1945 1940/44 1935/39 Under 15 Number immunised 72 840 1246 1087 857 4,622 4,797 13,521 Estimated mid-year child population 1949. Children under 5 7,175 Children 5-15 11,340 - ORTHOPAEDIC CLINIC. Toddlers and Adults School Children Primary examination by Surgeon 162 108 Re-examination by Surgeon 103 47 Cases treated 891 1,055 Treatments 11,522 7,965 TREATMENT OF DEFECTIVE VISION. Mothers and Toddlers Adults Public Scheme School Children Total Errors of Refraction,etc. requiring treatment 163 318 1057 1538 Spectacles prescribed 1 75 111 697 883 SKIN CLINIC.
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Consultations Treatments Sessions 51 152 Attendances : Children under 5 years 252 370 Children 5-15 years 363 2,161 Ante-Natal and Post-Natal cases 92 117 Other categories (including Public Adult Scheme) 188 588 10 DENTAL SERVICE. Mothers and Toddlers Adults- Public Scheme School Children Total Patients treated 1533 477 4802 6812 Attendances 4519 2567 12702 19788 Extractions 1882 392 5243 7517 Anaesthetics - General.
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594 104 2646 3344 Fillings 1387 313 6691 8391 Other Operations 2635 2818 6468 11921 Dentures supplied 247 525 32 804 Sessions (equivalent) 370 223 1089 1682 EAR, NOSE AND THROAT SERVICE Mothers and Toddlers Adults- Public Scheme School Children Total Attendances 245 45 839 1129 Cases which received operative treatment 27 _ 226 253 Cases which received other forms of treatment 108 31 355 494 SQUINT TRAINING Sessions 251 Children attended 147 Attendances 1673 Discharged - cured 10 11 PREVALENCE OF, AND CONTROL OVER INFECTIOUS AND OTHER DISEASES. NOTIFICATION.
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The following is a summary of the cases notified during the year:- Acute Anterior Poliomyelitis 15 Diphtheria 2 Dysentery 4 Erysipelas 21 Food Poisoning 39 Measles 603 Ophthalmia Neonatorum 3 Pneumonia65 Puerperal Pyrexia 13 Scarlet Fever 172 HOSPITALISATION. No difficulty was met in arranging for the admission of cases to hospital, and most cases went into the Ilford Isolation Hospital and Rush Green Hospital ACUTE ANTERIOR POLIOMYELITIS. 15 cases were notified during the year, and unfortunately death occurred in 3 cases. SCABIES. The following figures show that scabies was at a low ebb :- Cases Notified Cleansed at Barking Hospital. Adults 33 18 Children - 29 14 12 TUBERCULOSIS.
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The following table shows the number of cases added to the Register during the year:- NOTIFICATION OF TUBERCULOSIS. New Cases Notified. Pulmonary Non-Pulmonary Total M. F. M. F. Under 1 year 1 _ 1 2 1 to 5 years 2 2 1 1 6 5 " 15 " 6 5 1 1 13 16 " 25 " 25 36 3 2 66 26 " 35 " 16 11 2 4 33 36" 45 " 14 7 2 - 23 46 " 55 " 6 2 - — 8 56" 65 " 6 2 1 — 9 65 yrs and upwards. 1 1 - - 2 Totals 77 66 11 8 162 A total of 94 cases was removed from the Register during the year.
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13 SANITARY CIRCUMSTANCES OF THE AREA. STATISTICS. These will be found in the Appendix. CLIMATIC CONDITIONS. The rainfall for the year was 19.94" compared with 22.94" for the previous year. Barking is fortunate in being in one of the driest areas of the country,but is unfortunate in the fact that it suffers from atmospheric pollution, to which reference is made on pages , so that people living in the Borough are unable to get the maximum benefit from the sunshine available. WATER SUPPLY. There has been no change in the chemical quality of the water supply to the Borough, nor has there been any major extension of services. All the samples submitted, monthly for bacteriological examination and quarterly for chemical examination, have been found to be pure and wholesome. We still have need to complain of the hardness of the supply. RIVERS AND STREAMS.
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There was no serious flooding arising from any overflow of the rivers and streams in the Borough, but we did receive complaints as to the condition of the Mayesbrook watercourse, the River Roding and the River Thames. Negotiations were completed with the River Roding Catchment Board, the East Ham Corporation and frontagers for the filling in of the watercourse, known for a groat number of years as the Back River, which forms a boundary with East Ham on the western side of the Borough. The length of this stream was 740 yards. It is with pleasure I report the completion of this work, which resolved a nuisance which had existed for a number of years. During the year it was necessary to consult with the Essex County Council with regard to the pollution of the River Roding, and an inspection of tho Sewage Works delivering into that River was made in co-operation with their Officers. We were advised later of some necessary improvements which had been made at one of the Works.
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The offensive smells arising from the River Thames, and associated with the discharge of sewage effluents into the River, continued, and whilst there was no further deterioration in the chemical content of the River water, it was not possible to report 14 RIVERS AND STREAMS (contd) an improvement. I am aware that within the limits of money available the London County Council is continuing with the construction of now capital works for sewage disposal, but unless there is an increase in the speed with which this work is carried out, it does seem this nuisance will continue to cause discomfort to the residents of the Borough for a number of years. DRAINAGE AND SEWAGE. The whole of the drainage of the Borough is discharged to the Northern Outfall Works of the London County Council. There remains a small number of one-man trade premises at Rippleside where sanitary accommodation consists of a pail closet. The planning of this area has not yet been settled. PUBLIC CLEANSING.
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During the year 7,812 loads of refuse were collected with an average weight of 2.7 tons per load. It was with satisfaction from the public health standpoint that the Council ceased to collect food waste. If, for any national economic reasons, it should become necessary to reinstitute such a collection, I feel that this should not be done unless individual bins are provided for the use of every house. Private refuse tips - Essex County Council Act. 1933 Section 146. - Proceedings were instituted in connection with • contraventions at a private tip at Rippleside; a fine of £50 was imposed. Secondary Streets - I must still continue to report that the paving, lighting and drainage of those streets, which I regard as an urgent sanitary matter, has, by reason of the present economic stress, been left in abeyance. ERADICATION OF BED BUGS.
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There has been no important change in the position in the Borough, and whenever cases are brought to our notice disinfestation is carried out, and for this purpose an insecticide containing D.D.T. is used. The Housing Manager reports that 63 Corporation houses were treated during the year. 15 FLY NUISANCE. Special investigations were again carried out by Sanitary Inspectors of all places where flies were likely to breed, and particular attention was given to an area at Rippleside in the neighbourhood of a colony of 300 bungalows. A distribution of insecticide was made to the occupants of the bungalows, and a special spray treatment carried out in adjoining piggeries, stables and refuse tip where we found the source of the trouble. SMOKE MENACE. Monthly measurements of atmospheric pollution, both solid and gaseous, have been collected for a full year. The results demonstrate again the sharp rise in pollution in the winter months.
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Atmospheric pollution for the period October - March was 33% greater than that for the period April - September. The monthly supply of fuel used by factories for their industrial processes would be approximately constant throughout the year with a small increase in winter due to the need to heat the factory premises. The marked increase in the pollution of the atmosphere in the month of October is indicated in the table on page 18. This is the month when most people begin to light fires indoors, and it is reasonable to suppose that much of the increase may be attributed to domestic chimneys. There is no means of controlling pollution from this source by legal action, but efforts are being made both nationally and locally to encourage the use of smokeless fuels and the installation of grates suitable for this purpose.
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Houses now being erected by Local Authorities throughout the country are being equipped with grates capable of burning smokeless fuel, and it has been recommended by the Minister of Health that all houses reconditioned by a grant under the Housing Act, 1949, should bo similarly equipped. The burning of raw coal in inefficient open grates has long been considered wasteful. The old fashioned open grate has an efficiency of about 23% whilst a modern closable type of stove using smokeless fuel produces an efficiency of about 65% A vast amount of potential power is lost up the chimney in the form of unburnt gas, carbon and tar. It is the tarry content of domestic smoke which causes discolouration and disfigurntion of buildings duo to its adhesive nature. 16 Coal is a raw material from which can be produced a host of invaluable chemicals and compounds, including dyes,medicines, liquid fuels and gas, all of which are lost when coal is used in its raw state for heating.
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All factory chimneys in the area are kept under observation and contraventions of the byelaws have been dealt with. 298 observations of 30 minutes duration were made during the year and during these observations black smoke was emitted for a period of 134 minutes which represents an average of approximately minute in every 30 minutes observation. It has been found that contraventions are best dealt with by advice being given to factory owners by your officers who are suitably qualified for the work rather than by the institution of legal proceedings. In this way several improvements to furnace installations have been secured which have resulted in a reduction in smoke pollution of the atmosphere. Further progress in this direction is somewhat hampered by a long delay in the delivery of furnace equipment. This is specially true of installations designed to consume fuel such as wood chips and sawdust, several of which are to be found in the Borough.
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Unless strict attention is given to proper methods of stoking, these installations can cause nuisance from smoke or wood ash and your officers are alert to ensure that this necessary attention is given. Several installations are due for replacement as soon as more modern equipment becomes available. When such replacements are made, or when now installations are set up, efforts are made to secure plans of the boiler for approval prior to its erection. In this way it is possible to ensure that the boiler is of such design or is fitted with such equipment as will reduce the risk of atmospheric pollution to a minimum. That the task of reducing atmospheric pollution is an important one is obvious when one considers the large sum of money that has to be spent annually to make good the damage caused by smoke, and the many hours of cleaning made necessary by a dirty atmosphere. This has been estimated to be in the region of £100,000,000 per year.
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What is not always considered, however, is the interference by smoke with the beneficial ultra violet rays of the sun and the pollution of the soil which interferes with the growth of crops in gardens and allotments. 17 It has been demonstrated that the intensity of light in smoke polluted areas is only half that in a rural area, and that the ultra-violet radiation is reduced to an even greater degree. On many winter days the sun may bo observed as a red ball in the sky due to the fact that much of its power has been obscured by smoke particles. One of the most important positive values of sunlight is the way in which it promotes healthy bone growth in children. Adequate light promotes sturdy development and well-formed bodies preventing such deficiency diseases as rickets. It should not be necessary to take out children to the sea-side or to the country for sunshine and fresh air. These should be available all the year round in their home town.
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Sunlight is more directly essential to plant life than any other form of life, and in a smoky district the sunlight is not only reduced by the smoke haze, but also by the coating of soot that accumulates on the leaves. The result is that plants do not develop as they should. The remedy is to bo found in the co-operation of everyone, factory owners, engineers, stokers and householders to ensure that they are not responsible for pollution of the atmosphere. MEASUREMENT OF ATMOSPHERIC POLLUTION - 1949. Monthly Deposit in Tons per square mile and Sulphur Dioxide (Standard Measurement) by the Lead Peroxide method. Month Barking Park Greatfields Park Parsloes Park Total Solids Sulphur Dioxide Total Solids Sulphur Dioxide Total Solids Sulphur Dioxide January 20.94 39.5 35.55 46.9 29.65 46.4 February 19.44 31.9 28.68 41.
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7 28.23 39.2 March 15.22 27.5 24.44 23.1 21.01 26.4 April 24.16 17.6 27.37 22.9 28.99 24.1 May 25.08 12.2 26.93 16.9 26.89 15.6 June 17.25 9.4 21.56 15.0 19.88 12.7 July 27.89 6.6 26.11 9.6 22.66 7.3 August 23.78 8.9 32.34 11.2 24.97 9.6 September 20.94 6.7 25.46 9.0 26.65 8.3 October 44.35 18.4 51.81 23.8 47.90 24.5 November 21.42 13.
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5 33.98 25.9 32.98 29.2 December 19.44 27.1 29.23 40.7 24.83 35.7 18 RATS AND MICE.DESTRUCTION ACT.1919.AND INFESTATION ORDER.1943. RODENT CONTROL IN SEWERS. The biannual treatment of sewers was carried out during the months of May and November, Whilst the results on both occasions were satisfactory the evidence of heavy infestation in certain areas, most of which are in the older parts of the district, gives cause for serious thought. The following tables show the degree of infestation found to exist May Nevomber. Number of manholes baited 420 550 Number showing prebait take 279 260 Number showing complete prebait take. 166 106 Test baiting of 70 manholes throughout the newer parts of the district took place in April, and only evidence of minor infestation was found.
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Having regard to the result of the treatment in May, it was considered necessary to apply a special treatment to the sewers in the heavily infested areas. This was carried out with the approval of the Ministry in July using an alternative typo of bait base poison. The result of this treatment was as follows:- Number of manholes baited 210 Number of manholes showing prebait take 172 Number of manholes showing complete prebait take 102 A special record was made of the poison bait taken in these manholes as follows:- Number of manholes showing poison bait taken 130 Number of manholes showing complete bait taken 35 -19- SURFACE INFESTATION.
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In connection with the general surface infestation, the Corporation employs a trained rodent operative who has carried out 890 disinfestations as follows:- Factories and commercial premises 108 Private dwellings 232 Tips, open spaces, ditches and watercourses 72 Main and branch drains Corporation properties 39 Schools 10 Nurseries 2 This work involved over 4000 visits by the operative. The charge made by the Corporation for this service to factories and commercial premises is now at the rate of 4s. 3d. per man-hour, the managements of factories and business premises have continued to co-operate in this work, and the general public has taken advantage of the facilities offered. SWIMMING BATHS AND POOIS. the inadequate swimming facilities in Barking have caused concern to the Council for many years, and it is unfortunate that the proposed bath in Mayesbrook Park still had to be postponed. East Street Bath.
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This indoor bath was used by 74,588 bathers in the short season of 21 weeks, which constituted a record. It is pleasing to learn from the report submitted to the Council that 21,000 bathers were children, and whilst this is commendable, it does increase the problem of dealing with the pollution load using the present purification plant# Open Air Pool. the statistics submitted to the Council showed a welcome increase in the bathers attending the Open Air Pool, due to the excellent weather. There was a record attendance of 119,734 bathers for the season. -20- Generally, I can say that I look forward to the time when the now swimming bath is established, and provision made either centrally or in some part of the Borough for Turkish and vapour baths. Samples of swimming bath water were taken as below:- Number. Open Air Pool 6 East Street Bath 6 South East Essex County Technical College 7 FACTORIES ACT. 1937.
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In the Appendix will bo found statistics in relation to the administration of this Act. Out-workers. A fire occurred in a room where out-work was being carried on, causing the death of the outworker. The deceased was engaged in fixing rubber soles to shoes with an adhesive solution. the facts of this tragedy were reported to the Home Office. Arising from this incident the Council took proceedings against the employer of the out-worker who had failed to give notice in accordance with the Factories Act, 1937. The Magistrates imposed a fine of 40/-. SANITARY INSPECTION OF THE AREA. During the year the Sanitary Inspectors dealt with 1414 complaints which resulted in the service of 1041 Statutory Notices. At the end of the year there were 290 Statutory Notices outstanding. During the year work had been completed on 924 Statutory Notices and 897 preliminary Notices. MAINTENANCE REPORTS, Reference must be made to the difficulty in dealing with maintenance repairs.
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An appeal against a Notice under Section 9 of the Housing Act, 1936, on the grounds that the premises in question could not be repaired at a reasonable cost was made by the owner. It was urged on behalf of the Council that the premises could be repaired for an outlay of £60, but the Appellant claimed that the cost of discharging the Notice would be £139. -21- It was agreed that the value of the house on completion of repairs would bo £150. There were throe appearances at the County Court and the finding of the Judge was - "Having heard and considered all the evidence I accept as accurate the estimate that to execute the works specified in the Corporation's Notice will cost £139, and I find that to execute the works necessary to render this house fit for human habitation will cost such sum of £139. The result is that by expending the sum of £139 the Owners will have a house which will bo worth the agreed figure of £150.
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It will be observed that as the Ownor's net profit from the house thereafter will bo the agreed sum of £6 per annum, it will take 23 years before they will recover their expenditure of £139. It will also be observed that by expending £139 the Owners will increase the value of the house from its present agreed figure of £100 to £150 an increase in value of £50. On the whole facts I find that the house cannot bo rendered fit for human habitation at a reasonable expense." Notwithstanding this decision the owner shortly afterwards carried out the works required by the Notice. the date of the Notice under Section 9 of the Housing Act, 1936, was 14.9.48., and the works were completed in May,1950. Throughout this period the tenant was in occupation of the unsatisfactory promises, DUSTBINS.
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Since 1943 the Council have operated Section 75 (3) of the Public Health Act, 1936, and have supplied dustbins to any promises needing them, and at the same time giving notice to the owner. It was necossary to raise the annual charge for the maintenance of dustbins supplied to the sum of 5/-. This resulted in an appeal by many owner/occupiers for permission to withdraw from the "Council's Dustbin Schome", as it was called. It also created difficulties with owners of small cottages who felt aggrieved that they should be called upon to pay the additional charge. The controversial issue as to responsibility for the maintenance of dustbins is one which I should be pleased to see resolved. -22- ■ : CHEMICAL WORKS.
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Over a number of years, commencing from about 1933, the Council has received from residents in the neighbourhood of a factory situated on the site of the old Gas Works in Abbey Road, complaints of nuisances from fumes, smoke and noise, which they allege are produced by the operations of the factory and other works associated with it. These complaints have been pressed strongly during the last two years. The Public Health Committee appointed a sub-committee to discuss with the management what steps could be taken to mitigate the nuisance. The works have also been visited by the Alkali Works Inspectors of the Ministry of Health. the situation of the works is such that in the built-up area where the complainants reside nuisance is to be expected, and indeed, where such chemical processes are concerned, is impossible to avoid entirely. The real answer to the problem is for the factory to be re-sited. This,however, is Impossible with the present economic difficulties.
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MASSAGE & SPECIAL TREATMENT ESTABLISHMENT - ESSEX COUNTY COUNCIL ACT,1933, PART IV. there were three such premises licenced under this Act. Inspections have been made to ensure that the byelaws are complied with. RENT & MORTGAGE INTEREST RESTRICTIONS ACTS.1920 TO 1939. During the year two Certificates were issued under these Acts. HOUSING. STATISTICS. Your Chief Sanitary Inspector, who is Rehousing Officer for the Borough, has supplied the statistics, to be found in the Appendix, which show the detailed position in the Borough at the end of the year. POST-WAR HOUSING. Progress has continued with the Council's schemes. The majority of the building has been at Longbridge Road where there are 400 flats under construction.
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During the year the Council agreed in principle to the development of an area situated in the southern part of the Borough, but at the time of writing Ministerial consent has not been received for its use for housing purposes. It is important, if further building is to take place, that a decision should be obtained so soon as possible. -23- ■ . Clearance Areas and Re-Housing. It was not possible during the year to continue the re-development of the clearance areas in respect of which Orders were made early in 1939. Nevertheless, every attempt was made to maintain a reasonable standard of comfort for the 150 families living in the houses concerned. THE AGED AND THE TUBERCULAR. The problem of dealing adequately with the tubercular and the aged continues to receive the serious consideration of the Council, and whilst a start has not boon made on the building of the special hostel for the aged, the Council have proceeded so far as they can with the preliminary arrangements for this scheme.
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The additional 15 points awarded to the applications of tuberculous families is a substantial bonus, and does have the effect of securing the rehousing of all urgent cases. HUTTED CAMPS. During the year there was an increase in the number of families remaining in occupation of temporary dwellings. In order to relievo the acute overcrowding and as an emergency measure, the Council continued the conversion of a Ministry of Works hutted camp into housing units. As a result of our earlier experience with this type of converted dwelling, improvements were incorporated. Huts were divided by brick partition walls, and each family was provided with a bathroom and w.c. built into the unit, separate and under cover. In addition constant hot water supply was available from gas-heaters over sink and bath. The families in occupation of the accommodation were satisfied with this temporary rehousing at a rent of 10s. per week for two bedroom units.
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The number of complaints subsequently received have been few and have related to the ingress of dampness from roofs and windows in times of storm. -24- \ The following details of hutted camps are given:- Gunsite hutments 124 Huts for homeless 50 Thames Road conversions 54 The huts house a population of 795 persons, INSPECTION AND SUPERVISION OF FOOD. FOOD HYGIENE. The year has seen remarkable achievements in the restoration of war damaged food promises, Plate glass windows have again become normal and in general the shops have regained their pre-war appearance. It is pleasing to record that refrigerators have now become accepted as a standard fitment to any establishment where meat and other similar foods are stored for sale. Progress has also been made in fostering the co-operation of trade operatives and managements to raise the standard of cleanliness in food premises. Regular and frequent visits by your sanitary inspectors, who keep constant contact with all concerned, strengthen this desire for co-operation on both sides, FOOD POISONING.
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An increase in the number of notified cases of food poisoning is recorded. In all there were 39 cases which, upon investigation, were found to arise mainly from cockles which had been taken from an area under the control of the Port of London Authority. In investigating the matter 27 samples of cockles, obtained from local retailers, were submitted for bacteriological examination at the Central Public Health laboratories, who were unable to indicate any specific causative agent. SAMPLING. During the year 313 samples were submitted to chemical analysis, details of which are set out in the Appendix. The following five samples were reported to be unsatisfactory and were dealt with as shown overleaf. -25- Sugar - contained an admixture of approximately 14$ of potash alum. Bread - contained a piece of dirty dough. Beer - contained an excessive amount of load contamination.
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Salad Contravened Food Standards (Salad Cream Cream - and Mayonnaise) Order,1945, i.e., contained 22$ by weight of oil instead of required 25$. Cocktail Tonic - contravened Section 4 (iv) of the Food labelling Order,1946, i.e., found to be a non-alcoholic preparation and no appreciable quantity of fruit or vegetable juice present. In each instance appropriate action was taken. ICE CREAM SAMPLES - CHEMICAL EXAMINATION. There were 53 samples of ice cream analysed. It is gratifying to report that the improvement in the quality continues. Total Solids. Fat. Average sample contained 31.42% 8.86% Highest quality sample contained 37.90% 15.25$ Lowest quality sample contained 24.60% 2.90% The above figures support the argument expressed so frequently by you for a much higher fat content in all ice cream retailed.
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ICE CREAM SAMPLING - BACTERIOLOGICAL EXAMINATION. 105 samples of ice cream were bacteriologically examined. It is also the practice to submit these samples to the Ministry of Health Provisional Mothylene Blue Reduction Test for which the following results were obtained:- Satisfactory Unsatisfactory Bacteriological Examination: 84 21 Grades I & II Grades III & IV. Ministry of Health Provisional Mothylene Blue Reduction Test: 86 19 -26- MILK SUPPLY. In the area there are 31 promises registered for the retail sale of pro-packed supplies. There are six large purveyors of milk - one has premises in the district for the storage of milk only. Other than a small quantity of certified farm bottled milk, all the milk retailed is heat-treated. There were 75 samples of milk submitted to Methylene Blue Reduction Test, with phosphatase examination, of which 6 were reported unsatisfactory.
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the unsatisfactory samples occurred during the hot summer weather. A further 72 samples of milk were submitted for biological examination. Seventy were reported free from tuberculosis. In one instance the sample bottle was broken in transit and in another case the guinea-pig died prematurely. -27- APPENDIX. SANITARY INSPECTION (i) Inspection of Dwelling-Houses. Total Houses inspected under Public Health or Housing Acts 3,185 Total Number of Inspections made 10,650 After Infectious Disease and Scabies 770 Overcrowded Premises 494 Defects Found 3,710 Notices Served (Preliminary) 1,487 Re-Inspections re Notices Served 6,321 Inspection of Work in Progress 374 (ii) Promises Controlled by Bye-laws and Regulations. Inspections . Contraventions. Notices Served.
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Offensive Trades 67 25 12 Tents,Vans,Sheds and Fairgrounds 27 3 1 Dairies,Cowsheds and Milkshops 121 7 6 Hairdressers' and Barbers' Premises. 142 42 25 Smoke Observations 298 9 9 Massage etc. Establishments 6 - - (iii) Miscellaneous. Inspections . Defects. Noticos. Aged and Infirm Persons 21 - — Bakehouses 51 14 8 Butchers' Premises 430 70 42 Dilapidated Buildings 4 - - Drainage Inspections 235 187 90 Fishmongers 168 35 22 Food and Drugs Act,1938 995 200 97 Food Sampling 297 - - Ice Cream Vendors 391 45 31 -28- Inspections Defects. Notices.
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Licenced Promises 62 7 4 Milk Sampling 144 - - Other Miscellaneous 495 7 3 Piggeries 31 5 2 Public Lavatories 44 6 5 Rats and Mice (Destruction)Act,1919 219 29 27 Restaurants,Dining Rooms and Canteens 456 118 64 Schools 86 - - Shell Fish Sampling 19 - - Shops Act, 1934, Markets and Street Traders 894 114 70 Stables and Stable Yards 45 3 3 Vacant Land and Refuse Tips 175 2 2 Watercourses 20 - - Water Sampling 62 - - (iv) Notices Served.
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Informal Notices 1,487 Statutory Notices:- Public Health Act,1936: Section 39 209 Section 45 50 Section 83 1 Section 93 424 Housing Act,1936: Sections 9 and 10 35 Section 24 - Section 32 - Factories Act, 1937: Section 7 - Dustbins: Public Health Act,1936: Section 73(3) 322 Total 1,041 -29- FACTORIES ACT.1937. 1, - Inspections for purposes of provisions as to health (including inspections made by Sanitary Inspectors). Premises. Number on Register Number of Inspections . Written Notices Occupiers prosecuted (i) Factories in which Sections 1,2,3,4 and 6 arc to be enforced by Local Authorities. 53 76 8 - (ii) Factories not included in (i) in which Section 7 is enforced by the Local Authority.
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204 362 56 - (iii) Other Promises in which Section 7 is enforced by the Local Authority (excluding outworkers' premises) 8 1 1 - Total 265 439 65 - -30- - 2. - Cases in which Defects were found. Particulars No. of cases in which defects were found. No. of cases in which prosecutions were instituted. Found Remedied Referred To H.M.
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Inspector By H.M, Inspector Want of cleanliness (S.1) 18 18 - - - Overcrowding (S.2) - - - - - Unreasonable temperature (S.3) - - - - - Inadequate ventilation (S.4) 4 4 - - - Ineffective drainage of floors (S.6) - - - - - Sanitary Conveniences (S.7) (a) Insufficient 4 4 - 1 - (b) Unsuitable or defective 81 70 - 12 - (c) Not separate for sexes 1 1 - - - Other offences against the Act (not including offences relating to Outwork) 4 4 - - - Total 112 101 - 13 - -31- OUTWORK.
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Soction 110: Number of out-workers in August List required by Section 110 (l) (c) 236 Nature of work carried out by out-workers:- Making of wearing apparel 187 Cleaning and washing of wearing apparel - Umbrellas, etc 1 The making of boxes or other receptacles or parts there of made wholly or partially of paper 16 Brush making - Cosaques, Christmas Crackers, Christmas Stockings, etc 22 Artificial flowers 1 Confectionery Novelties 4 Eiderdown Covers 1 Toys 3 Life Saving Equipment 2 Number of cases of default in sending in lists to the Council 1 Prosecutions for default in sending in lists to the Council 1 Section 111; Number of visits to ourworkers 378 Number of instances of work in unwholesome premises Nil Number of notices served Nil Number of prosecutions in respect of out-workers' premises Nil -32- EC JiV, HOUSING STATISTICS. (a) General.
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(i) Number of dwellings provided in Barking during 1949: By the Barking Corporation: New dwellings 215 Rebuilt houses - Prefabricated bungalows - Total 215 By the London County Council; Rebuilt houses 18 Prefabricated bungalows - Total 18 By Private Enterprise: New houses 3 Rebuilt houses 40 Total 43 Total dwellings provided 276 (ii) Number of dwellings provided in Barking since the war: By the Barking Corporation: New permanent dwellings 475 Prefabricated bungalows 285 Rebuilt houses 57 St.
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Paul's Flats (Conversion of Civil Defence Depot) 11 Thames Road Hutments 54 Hutments for homeless 50 Hutted camps 113 Requisitioned properties 459 Rebuilt requisitioned properties 5 Total 1509 By the London County Council: Rebuilt and now houses 191 Prefabricated bungalows 337 Total 528 By Private Enterprise: New houses 26 Rebuilt houses 130 Total 156 (iii) Post-war Housing programme of the Barking Corporation; Prefabricated bungalows 285 ( all erected and let) New permanent dwellings 786 ( 475 erected and let) Rebuilding of properties 63 ( 57 erected and lot) Rebuilding of requisitioned properties 5 ( all completed and let) Total 1139 (b) Housing Applications. No.
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of names on waiting list at beginning of year 1949 3488 ,, ,, ,, added to list during 1949 807 ,, ,, ,, removed from list during 1949 1394 ,, ,, ,, remaining on list at end of year 1949 2901 (c) Applications for Transfer to other Accommodation. No. of applicants for transfer at beginning of year 1949 352 ,, ,, transfers effected 118 ,, ,, mutual transfers 72 ,, ,, applicants for transfer at end of year 1949 705 (d) Lettings. Mayesbrook Estate 108 Wostrow Drive Estate 20 St.Awdry's Road 13 St.John's Road/Devon Road 10 Longbridge Road Flats 24 Various 160 Rohoused by L.C.C 117 -34- Unfit Dwelling-Houses. l. Inspection of dwelling-houses during the year.
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(1) (a) Total number of dwelling-houses inspected for housing defects (under Public Health or Housing Acts) 3,185 (b) Number of inspections made for the purpose 10,650 (2) Number of dwelling-houses found to be in a state so dangerous or injurious to health as to be unfit for human habitation - (3) 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 1,581 2. Remedy of Defects during the Year without Service of Formal Notice: Number of defective dwelling-houses rendered for in consequence of informal action by the Local Authority or their officers 990 3. Action under Statutory Powers during the Year. A.- Proceedings under Sections 9,10 and 16 of the Housing Act,
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1936:- (1) Number of dwelling-houses in respect of which notices were served requiring repairs 35 (2) Number of dwelling-houses which were rendered fit after service of formal notices:- (a) By owners 24 (b) By Local authority in default of owners 5 B.- Proceedings under Public Health Acts:- (1) Number of dwelling-houses in respect of which notices were served requiring defects to be remedied 684 (2) Number of dwelling-houses in which defects were remedied after service of formal notices:- (a) By owners 496 (b) By local authority in default of owners 8 (c) By local authority on behalf of owners 13 -35- C.- Proceedings under Sections 11 and 13 of the Housing Act,1936: (1) Number of dwelling-houses in respect of which Demolition Orders were made - (2) Number of dwelling-houses demolished in pursuance of Demolition Orders - D.- Proceedings under Section 12 of the Housing Act,
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1936: (1) Number of separate tenements or underground rooms in respect of which closing orders were made - (2) Number of separate tenements or underground rooms in respect of which closing orders were determined, the tenement or room having been rendered fit - E.- Number of dustbins supplied by local authority under Dustbin Maintenance Scheme: Initial Issues 322 Renewals 452 Total 774 4. No. of dwelling-houses demolished without Statutory action 5 I ■ • . ....... INSPECTION AND SUPERVISION OF FOOD. MILK SAMPLES - BACTERIOLOGICAL EXAMINATION 1949. Type of Sample Satisfactory Unsatisfactory. Totals "Pasteurised" Milk 43 3 46 Tuberculin Tested Milk. 8 3 11 Tuberculin Tested (Pasteurised) Milk 16 1 17 Totals 67 7 74 UNSOUND FOOD CONDEMNED - 1949. Bacon 53 1bs.
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Beverages (Tea,coffee,cocoa) 54 1bs. 16 bottles. Bread, Flour, Biscuits 197 1bs. Butter 5i 1bs. Cakes 24 1bs. Cereals, various 132 1bs. Cheese 169 1bs. Confectionery . 72 1bs. Cooking Fat 4 1bs. Dried Fruits 52 1bs. Drinks (Non-alcoholic) 19 bottles. Eggs, Dried 1 carton. Fish (tinned) 203 tins. Fish 3,634 lbs. Fruits 86 tins. Ice Cream 200 lbs. Jam 468 lbs. Jelly, custard, junket,etc 20 pkts. Meat 1,284 1bs. Milk 823 tins.
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Mi1k, dried 9 tins. Pickles, Sauces, etc 116 pints. Puddings (tinned) 142 1bs. Rabbits 171 1bs. Sausages 53 1bs. Soups 339 tins. Sugar 4 1bs. Syrup 6 1bs. Tongue (tinned) 7 1bs. Vegetables (dehydrated) 15 1bs. Vegetables (tinned) 549 1bs. Various fillings 493 tins, jars, etc. -37- ... •I. ... ... ... . FOOD AND DRUGS ACT,1938 - GAMPLES SUBMITTED FOR EXAMINATION - 1949.
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Apple Conserve 2 Beverages (Tea, coffee, cocoa) 2 Beer 7 Black pudding 4 Bread 2 Butter 15 Coffee extract 4 Chicken Broth 1 Cooking Fats 7 Custard Powder 5 Cereals 1 Curry Powder 1 Doughnuts 1 Essences 1 Fish Paste 4 Flour & Cake Mixtures 7 Gelatine 2 Gravy Powder 2 Jelly Crystals 2 Herbs, mixed 1 Horseradish sauce 3 Ice Cream 53 Medicinal products . 8 Milk 14 Mineral Waters / Cordials/Non-Alcoholic Wines 17 Margarine 13 Meat Paste. 1 Lemonade Crystals 3 Lord . 3 Mincemeat 1 Meats (pressed & potted) 5 Preserved (Jams, Marmalade,otc.)
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23 Pepper 1 Potato Crisps 3 Red currant Jolly 1 Olive Oil 1 Onion Powder (dehydrated) 2 Sago & Onion Stuffing/Thyme 3 Salad Cream & Salad Dressing 8 Sausages & Sausage Meat 29 Soups & Soup Powders 3 Sugar 1 Vinegar 4 Sauces,Pickles,etc 13 Spirits 17 Various fillings 5 Spaghetti & Tomato Sauce 1 Suet 2 Sweetmeat, toffee,etc 4 313 -38- % III • » • t« • • t k * • * ' • ft 7 • • • • • • t III 4 . I • A
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411 (1) BARK 73 BOROUGH OF BARKING. ANNUAL REPORT (ABRIDGED) OF THE MEDICAL OFFICER ON THE HEALTH OF THE CHILDREN OF BARKING FOR THE YEAR 1949. C. Leonard WILLIAMS, B,Sc., M.R.C.S., L.R.C.P., D.P.H. Public Health Department, Barking, Essex. November, 1950. To the Chairman and Members of the Barking Committee for Education. I beg to submit my Abridged Report for the year ended 31st December, 1949. I am, Your obedient servant, C. LEONARD WILLIAMS. Medical Officer. 1 MEDICAL INSPECTIONS. During the year nine thousand four hundred and eighty children were medically examined at school, which represents seventy-five per cent. of the total school population. In addition there were twenty-four thousand three hundred and eighty special inspections and re-inspections at your various Clinics.
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The Statistical Return at the end of this Report shows the classification of defects found at these examinations and re-examinations. NUTRITION. Of the nine thousand four hundred and eighty children medically examined at school, three thousand nine hundred and nine were found to be of good nutritional standard; five thousand four hundred and seventy-eight were fair (that is, of normal nutrition), and only ninety-three were of poor nutritional standard. These results compare very favourably with those for 1948. MINOR AILMENT CLINICS. Minor Ailment Clinics were held daily at Central, Woodward, Porters Avenue and Upney, and the total attendances during the year were twenty-nine thousand two hundred and ninety-one. 2 DENTAL INSPECTION AND TREATMENT. We were unable to increase our staff of four to the approved establishment of six Dental Officers, so that it was impossible to undertake the number of dental inspections at school at which we aim.
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Pour thousand eight hundred and two children were actually treated, compared with over six thousand the previous year. ORTHODONTIC TREATMENT. The orthodontic treatment of school children was maintained at your Dental Clinics, and one hundred and fifty-nine orthodontic aopliances were provided. EAR, NOSE AND THROAT CLINIC. t Mr. Courtemay Mason, F.R.C.S., Consulting Ear, Nose and Throat Surgeon, continued to hold weekly sessions at Central Clinic, and eight hundred and thirty-nine attendances were made. Two hundred and twenty-six children received operative treatment for ear, nose and throat conditions at King George Hospital, Ilford; Queen Mary's Hospital, Stratford; and St. Mary's Hospital, Plaistow. 3 OPHTHALMIC CLINIC. Dr. R, Jamieson succeeded Mr.
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J. Ayoub, P.R.C.S., as your Consulting Ophthalmic Specialist in March, and continued to attend twice weekly at both Central and Woodward Clinics. Altogether three hundred and seventy-five new cases were seen; spectacles were prescribed for six hundred and ninety-seven children, and there were total attendances of two thousand three hundred and fifteen. ORTHOPTIC CLINIC. The Orthoptic Clinic continued under the supervision of your Ophthalmic Specialist. One hundred and forty-seven cases were given squint training, and these cases made one thousand six hundred and seventy-three attendances during the year. ORTHOPAEDIC CLINIC. Mr. A.M.A. Moore, F.R.C.S., your Consulting Orthopaedic Surgeon, held nineteen sessions at which one hundred and fifty-five children were seen.
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So far as orthopaedic treatment was concerned, there were times during the early part of the year when we had one only physiotherapist, and although the position improved at no time did we have our full complement of staff. One thousand and fifty five children received treatment, of which four hundred and thirty-eight attended for ultra-violet light, and during the year the total attendances at the Orthopaedic Clinic were eight thousand one hundred and twenty. 4 SKIN CLINIC. Dr. Deville, your Specialist Consultant in Skin Diseases, held weekly sessions in Paget Ward at the Barking Hospital. One hundred and ninety-one new cases were seen by Dr. Deville which was an increase of only eighteen over the number seen in 1948. In addition eight hundred and ten new cases were seen by your Medical Officers at other OutPatient Skin Clinics.
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Over four thousand attendances for the treatment of skin conditions were made during the The following table shows that there has been a most satisfactory decrease in the number of children requiring treatment for Scabies during the past four years:- 1946 1947 1948 1949 2 31 110 32 12 PAEDIATRIC CLINIC. Dr. A. Doyne Bell, your Children's Specialist Consultant, resigned in November and was succeeded by Dr, S.B. Dimson. This Clinic continued to be held on alternate Thursdays, and during the year one hundred and ten attendances were made. 5 SPEECH THERAPY. The Speech Therapy Clinic held in the Paget Ward of Barking Hospital was closed for nearly two months whilst we were without a Speech Therapist. Since June, however, a full-time Speech Therapist has been engaged, and during the year over eighty children have attended for treatment. FOOT CLINICS.
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Five hundred and ninety-five children attended at the Foot Clinics during the year and one thousand three hundred and twelve treatments were given. This showed a slight decrease as compared with 1948. SCHOOL CAMPS. Five hundred and seventy-three children were medically examined before their admission to Hydon Heath and other Camps. If, at this examination, some minor defect was found everything possible was done to arrange immediate treatment so that the child should not be deprived of the opportunity of going away to Camp. UNCLEANLINESS INSPECTIONS. Although there were three thousand more uncleanliness inspections at school during the year than in 1948, there was an increase of only fourteen pupils found to be infested. 6 INFECTIOUS DISEASES AMONGST SCHOOL CHILDREN. (a) Scarlet Fever. One hundred and five children were notified as suffering from Scarlet Fever during 1949, compared with eighty-four in 1948. (b) Whooping Cough.
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There was a decrease in the number of cases of Whooping Cough, eighty-one being notified in 1949, and one hundred and sixteen in the previous year. (c) Measles. There was a very considerable decrease in the number of Measles notifications; there being only one hundred and sixty-four this year as against five hundred and twentythree in 1948. (d) Diphtheria. One only case of Diphtheria was notified, whilst in the previous year there were seven. IMMUNISATION. Immunisation against Diphtheria was carried out by your Medical Officers not only at the Clinics but at schools also, and at the end of the year no less than 83 per cent. of the school population were immunised against Diphtheria. 7 HANDICAPPED PUPILS.
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The physically-handicapped, delicate, and educationally sub-normal children attending Faircross Day Special School continued to receive constant medical supervision, twentythree sessions of medical inspection being carried out at the school during the year. The number of physically-handicapped and delicate children on the roll at the end of the year was sixty-three, which included nine from Dagenham and East Ham. There were ninety-five educationally subnormal children in attendance at the school, although of this number sixty-one came from Ilford, Dagenham and East Ham, Six children from this area attended Tunmarsh Lane (Day) Deaf Centre, West Ham. Other handicapped children were treated in residential special schools as under:- Educationally sub-normal: 1 Epileptic: 1 Physically-handicapped: 1 Blind: 1 Partially blind: 1 Partially deaf: 1 8 CONVALESCENT TREATMENT.
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During the year arrangements were made for convalescent treatment (up to a maximum of eight weeks) in thirty-four cases. In four other cases, where more prolonged treatment was considered necessary, the children were admitted to Boarding Open-Air Schools. FOLLOWING-UP. "Following-up" work by your Health Visitors and School Nurses is, of course, a material factor in maintaining and, indeed, improving the general level of the health of your school children. This work has been carried out successfully during the year and one thousand four hundred and forty-two home visits were made. 9 SCHOOL HEALTH SERVICE. MEDICAL INSPECTION RETURNS. Year ended 31st December, 1949. TABLE I. Medical Inspection of Pupils attending Maintained Primary and Secondary Schools. A. PERIODIC MEDICAL INSPECTIONS.
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Number of Inspestions In the prescribed Groups: Entrants 1,687 Second Age Group 1,432 Third Age Group 1,134 Tota1 4,253 Number of other Periodic Inspections 5,227 Grand Total 9,480 B. OTHER INSPECTIONS. Number of Special Inspections 12,126 Number of Re-Inspect ions 12,254 Total 24,380 10 TABLE I. (Contd.) C. PUPILS FOUND TO REQUIRE TREATMENT. Number of Individual Pupils found at Periodic Medical Inspection to Require Treatment (excluding Dental Diseases and Infestation with Vermin). Group For defective vision (excluding) squint) For any of the other conditions recorded in Table IIA.
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Total Individual pupils (1) (2) (3) (4) Entrants 10 232 222 Second Age Group 43 132 159 Third Age Group 48 106 141 Total (prescribed groups) 101 470 522 Other Periodic Inspections 256 509 655 Grand Total 357 979 1,177 11 TABLE II. A. RETURN OP DEFECTS POUND BY MEDICAL INSPECTION. Defect Code No. Defect or Disease. Periodic Inspections Special Inspections No. of defects No. of defects Requiring Treatment under Observation but not requiring Treatment Retiring Treatment Requiring to be kept under Observation but not requiring. Treatment (1) (2) (3) (4) (5) 4. Skin 169 35 930 8 5. Eyes-a.
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Vision 357 33 217 9 b. Squint 21 11 92 - c. Other 19 10 574 - 6. Ears-a. Hearing 30 5 43 2 b. Otitis Media 16 7 28 2 c. Other 18 15 331 19 7. Nose or Throat 227 153 225 62 8. Speech 28 13 40 4 9. Cervical Glands 4 21 31 16 10. Heart and Circulation 16 26 19 20 11. Lungs 37 74 43 68 12. Developmenta1- a. Hernia 10 7 2 - b. Other 1 12 2 1 13.
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Orthopaedic- a. Posture 17 14 12 - b. Plat Foot 112 44 14 - c. Other 178 83 54 3 14. Nervous system- a. Epilepsy 2 9 2 - b. Other 16 40 20 11 15. Psychologica1- a. Development 4 17 38 3 b. Stability 4 10 11 9 16. Other 499 174 6,495 168 12 TABLE II. (Contd.) B. CLASSIFICATION OF THE GENERAL CONDITION OF PUPILS INSPECTED DURING THE YEAR IN THE AGE GROUPS. Age Groups. Number cf Pupils Inspected A.* (Good) B. (Fair) C. (Poor) No. % of col. 2, No. % of col. 2. No. % Of col. 2.
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(1) (2) (3) (4) (5) (6) (7) (8) Entrants 1,687 924 54.77 740 43.87 23 1.36 S e c o nd Age Group 1,432 589 41,13 836 58.38 7 .49 Third Age Group 1,134 464 40.92 663 58.46 7 .62 Other Periodic Inspections 5,227 1,932 36.97 3,239 61.96 56 1.07 Total 9,480 3,90 9 41.23 5,478 57.79 93 .98 A, - Excellent Nutrition. B. - Normal Nutrition. C. - Slightly sub-normal Nutrition. 13 INFESTATION WITH VERMIN.
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(i) Total number of examinations in the schools by the school nurses or other authorised persons17,341 (ii) Total number of individual pupils found to be infested 477 (iii) Number of individual pupils in respect of whom cleansing notices were issued (Section 54 (2), Education Act, 1944) 143 (iv) Number of individual pupils in respect of whom cleansing notices were issued (Section 54 (3), Education Act, 1944) - 14 TABLE IV. TREATMENT TABLES. GROUP I. - MINOR AILMENTS (excluding Uncleanliness, for which see Table III) (a) Number of defects treated or under treatment during the year. Skin - Ringworm - Scalp - (i) X-ray treatment.
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If none, indicate by dash 1 (ii) Other treatment 2 Ringworm - Body 7 Scabies 12 Impetigo 125 Other skin diseases 943 Eye Disease (External and other, but excluding errors of refraction, squint and cases admitted to hospital). 775 Ear Defects 523 Miscellaneous (e.g. minor injuries, bruises, sores, chilblains, etc). 6,407 Total 8,795 (b) Total number of attendances at Authority's minor ailments clinics 29,291 15 TABLE IV. TREATMENT TABLES. (Contd.) GROUP II. - DEFECTIVE VISION AND SQUINT (excluding Eye Disease treated as Minor Ailments - Group I). No, of defects dealt with. ERRORS OF REFRACTION (including squint) 1,037 Other defect or disease of the eyes (excluding those recorded in Group I) 20 Total 1,057 No.
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of Pupils for whom spectacles were (a) Prescribed 697 (b) 0 b t a i ne d 648 GROUP III. - TREATMENT OF DEFECTS OF NOSE AND THROAT. Total Numbertreated. Received operative treatment - (a) for adenoids and chronic tonsillitis 219 (b) for other nose and throat conditions 7 Received other forms of treatment 355 Total 581 16 TABLE IV. TREATMENT TABLES. (Contd.) GROUP IV. - ORTHOPAEDIC AND POSTURAL DEFECTS. Total number treated. (a) No. treated as in-patients in hospitals or hospital schools 2 (b) No, treated otherwise, e.g. in clinics or outpatient departments 1,055 GROUP V. - CHILD GUIDANCE TREATMENT AND SPEECH THERAPY. Total number trea ted. No.
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of pupils treated - (a) under Child Guidance arrangements 6 (b) under Speech Therapy arrangements 85 17 TABLE V. DENTAL INSPECTION AND TREATMENT. Total number treated.
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(1) Number of pupils inspected by the Authority's Dental Officers - (a) Periodic Age Groups 2 ,660 (b) Specials 2,225 (c) TOTAL (Periodic and Specials) 4,885 (2) Number found to require treatment 3,782 (3) Number actually treated 4,802 (4) Attendances made by pupils for treatment 12,702 (5) Half-days devoted to: (a) Inspection 19 (b) Treatment 1,070 Total (a) and (b) 1,089 (6) Fillings: Permanent Teeth 4,678 Temporary Teeth 2,013 Total 6,691 (7) Extractions: Permanent Teeth 1,092 Temporary Teeth 4,151 Total 5,243 (8) Administration of general anaesthetics for extraction 2,646 (9) Other Operations: (a) Permanent Teeth 6,459 (b) Temporary Teeth 9 Total (a) and (b) 6,468 18
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Journal Rebind Co, Ltd. Unit 4, pier wharf Gravs Fsser BARK 44 AC4411(1) BARKING LIBRARY The HEALTH of BARKING 1950 The Annual Report of the Medical Officer of Health, Borough of Barking: C. LEONARD WILLIAMS, B.Sc., M.R.C.S., L.R.C.P., D.P.H. 67953 BARK 44 TOWN HALL, BARKING, ESSEX October, 1951. To the Mayor, Aldermen and Councillors of the Borough of Barking. Mr. Mayor, Ladies and Gentlemen, Like a gramophone record which has been damaged or, if I may say so, like a recurring decimal, I have to repeat, as I have said before, how sorry I am that this Annual Report is so late.
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I do apologise, but I would say in mitigation that our lives are becoming more and more crowded and often it is taking me too long to do too litte and it is becoming difficult, well nigh to the point of being impossible, to keep up with things. Old men always look back to the days of their youth and say they were much better—they have always done so. 'hat I am trying to do is to look at this matter objectively—were the old days better so far as administration is concerned or is it only that I think them so? Unhesitatingly, I say I am very happy that so much of my work was done when administration was much simpler and more straightforward than it is to-day. May I be permitted to apologise once again for this Report being so 1ate. I am, Mr. Mayor, Ladies and Gentlemen, Your obedient Servant, Medical Officer of Health.
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SOCIAL CONDITIONS AND GENERAL PROVISION OF HEALTH SERVICES THE WASTAGE OF HUMAN LIFE What are the chief causes of death to-day? Years ago diphtheria and smallpox would have been rated high but, to-day, their mention holds little terror for the public generally, although in the section dealing with infectious diseases I shall be recording a word of warning about them. Cancer If we examine the causes of death for 1950, we find that 129 Barking people died from cancer. Deaths from this disease form one-fifth of the total deaths recorded annually in Barking and in the County generally. Cancer is one of the most dreadful of diseases and I should like to explain simply what it is and to show how mere figures about it can be misleading. The tissues of the body are made up of cells in the same way as a building is made of bricks, slates and other things.
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Tissue like a building requires constant repair and renovation and normally the cells forming the tissue multiply just sufficient to effect this repair and renovation. Cells which are cancerous, however, just grow and multiply without any regard to the requirements of the body as a whole. They demand feeding even though this means that the rest of the body is famished and the tumour which is formed insists on growing and growing even though it is pressing on some vital part of the body. These cells are parasitic so far as the ordinary cells of the body are concerned. During the year 1950, 22 people in Barking died from cancer of the lungs. Some of these cases were cancer of the lung tissue proper, and some of these cases cancer in the air-ways of the lungs. Twenty years ago when the population of Barking was only about 40,000 instead of 80,000 we had four cases recorded.
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A statistician would jump to the conclusion that cancer of the lungs was much more than it used to be, but I would ask you to pause, because in or about the year 1928 I was called out to examine a case of query tuberculosis and I came to the conclusion it was cancer of the lung. Quite frankly, I felt myself a bit of a clever doctor, because it had been Page 3 missed until I had examined the patient. As a matter of fact, I was not half so clever as I thought myself, or anyhow, I do not think so looking back on it now. This is a measure of the difficulty there was in diagnosing cancer of the lungs. Nowadays, with the all-seeing eye of an X-ray, the diagnosis is reasonably simple. Obviously, many more cases can be detected and although I have no doubt that people will hold the view that cancer of the lung is on the increase, I myself want further facts before I am willing to accept this point of view.
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It is because of this second point of mine that I want everybody to treat with the utmost reserve hasty conclusions based upon statistical evidence, because I believe the statistical evidence can be quite misleading. I am not disparaging the possibility of some wonderful curative drug being found. Such marvels have been achieved in the last 25 years that it would not behove anybody to say he did not believe this can be done or that can be done. I have a feeling, however, that such a wonderful drug is not just round the corner. This, however, appears to me to be abundantly proved, cancer never occurs in a healthy organ. It is always preceded by one disease or another disease and it is my opinion that our highest hopes can be pinned upon a healthy and a more healthy life. I am convinced it is the sanitarian, using that word in its widest sense, who holds out the highest hope for any real relief from this most dreadful disease.
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Heart Disease Nearly a third of the deaths which occur annually are due to or are associated with heart disease. There has been a significant increase in the number of deaths attributed to this and allied causes during the past 50 years and perhaps research which is progressing will confirm or otherwise that the increased tempo of this modern age is a significant factor in this increase. Accidents The ever-increasing complication of life generally provides more sources of potential danger to life through accidents at home, at work, at play, in travel, particularly on roads, and so on. Successful efforts have been made, particularly in Barking, to minimise danger on the roads but there is still much to be done in other Page 4 directions, for instance, to reduce the number of children who are killed or injured, especially through burning, in the home.
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The wastage of human effort caused through accidents can be gauged from the fact that in 1949 acute anterior poliomyelitis (infantile paralysis) which causes so much fear in the public mind accounted for under 700 deaths in England and Wales, whereas fatal road accidents claimed nearly 5,000 victims and injured approximately 20 times as many more. When we compare the concern caused by such diseases as poliomyelitis it is disquieting to know that the public has yet to show a proper appreciation of "SAFETY FIRST." Tuberculosis Present day conditions demand that the greatest use shall be made of potential manpower, but much effort is lost to the national economy through tuberculosis. We are ever reminded of the tragedy of this disease by the long waiting lists for the too few sanatorium beds and the calls which are being made upon the after-care services for patients being nursed at home, e.g., sick-room equipment, domestic helps, district nurses. The only answer is prevention.
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Mass miniature radiography units have provided a medium for ensuring early detection, but the public generally has yet to appreciate fully the value of the work which is being done by these units. In my opinion, there are too few units available at the present time and parallel with this there is a large section of the public who, by their apathy have yet failed to create a positive demand for more units. In defence of the public it must be stated that so far as Barking is concerned we can only expect the visit of a Unit once for a few weeks every three years. There does seem much to support the view that a more or less local unit would foster the habit of an annual check-up. Some large industrial undertakings already have their own units, and based on their experience it is estimated that one unit could be operated economically if it were to serve an urban population of about 250,000.
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Barking is fortunate in having been chosen as one of the districts in which parents of children leaving school have been invited to allow their children to take part in the trials being conducted by the Medical Research Council into the potential value of B.C.G. vaccination. The Page 5 response of Barking parents has been very good indeed and it is hoped that if the trials prove successful B.C.G. vaccination will be made available to a much wider section of the community. Infant Mortality It will be seen from the tables on page 34, that during 1950 a total of 32 Barking children died under the age of one year. Of this total no less than 20 died within the first month of life, with prematurity being given as the cause of death in half the cases. Breaking these figures down still further we see that 18 deaths occurred within the first week of life and that of these no less than 9 were under one day old.
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It will be noted, too, that two deaths were caused by accident—one by suffocation and one by burning. The infant mortality rate for Barking for 1950 is 27.0 and the table on page 35 gives the rates for the past 25 years. It is pertinent to point out that whereas great reductions have been made in infantile deaths, the number of still-births remain more or less constant and during 1950 no less than 26 were recorded. There still remains much to be done in reducing the number of deaths in the first weeks of life and of still-births. MORTUARY FACILITIES For a long time now mortuary accommodation in Barking has been sub-standard, and I am happy to say that during 1950 you took the first step towards a real improvement in this matter. A conference was convened with the object of discussing the possibility of providing a mortuary to serve Ilford, Dagenham and Barking.
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It is proposed to make this a joint effort because it is so very expensive to have a separate mortuary for each town. The number of post-mortems carried out each year is more or less constant over such an area and I have no doubt that such a joint venture would enable us to undertake a difficult service in a satisfactory way. Particularly, I am intrigued with this idea, because it will make it economically possible to have a Chapel of Rest where friends and relatives, Page 6 if they so desire, can view their loved ones in dignified surroundings. This is in sharp contrast to the gruesome conditions which prevail in outof-date mortuaries, Barking's included.
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A man cannot be so old as I am without having learned how difficult it is, and, I may say dangerous, to try to interfere with the customs and usages of any country which have to do with marriage and death, and I certainly have no intention of trying to coerce people and make it obligatory for them that their loved ones, when they have passed away, shall rest for the time being in a public mortuary. This idea, however, is growing and whilst on the one hand I would not do anything to force people to do this or to do that, I do think that we should give every facility to those who are willing for their relatives and friends to rest under conditions which are suitable to the occasion. Our houses of to-day, of necessity, are built not overlarge and some of our houses at the present time are overcrowded. This makes it highly desirable that when we are making provision for mortuary accommodation such provision should be of the very highest order.
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It should be designed in such a style as to reflect all the respect which we have for the dead. In the proposed new mortuary, it is envisaged also that refrigeration facilities will be available, a very desirable feature during summer months. THE WELFARE OF THE AGED There is an increasing awareness of the need to give greater attention to the general welfare of the aged, and the following extract of a letter I have written to an architect recently gives some idea of the problems which have to be tackled, and in particular those relating to homes:— "It is with pleasure that I learn you are turning your attention to houses for aged people, and I do look forward to taking an interest in this work, even as you have privileged me to take an interest in other work you have carried out. "It is, I think, wise for us to begin to study the size of the problem with which we are dealing. Towards the end of the last, and at the beginning of this century 4.5 per cent.
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of the population were 65 years or over, whereas now there are no less than 11 per cent. of the population over this age. To a certain extent this is due to preventive medicine which has increased the expectation of life generally, to improved social welfare, and, to a certain degree, it is Page 7 due to improved medicine which has brought it about that at the age of 65 people have a longer expectation of life than they had 50 years ago. Of course, it may be due to the fact that a relatively large number of babies were born at the turn of the century, and that, therefore, we should now normally expect a lot of people of the age of 65 and upwards.
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"I mention these facts to show that an alteration in social conditions, and particularly fluctuations in the birth rate, may possibly mean that the problem to-morrow will not be the same as the problem to-day, and having regard to the fact that the life of a house is from 50 to 100 years, we ought to think about the problem of to-morrow before we assess what is the size of the problem with which we should deal to-day. However, insofar as not for many years are we likely to build too many houses of this sort, we need not worry our heads about it, save only to remember that the problem is there. "To put the thing in a nutshell, our personal problem is not so much adding years to life as it is adding life to years.
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We know people of 60 and 70 are much more spry than they were 50 years ago, and I see no reason why, in the future, people should not lead active and useful lives at an age when years ago it would have been looked upon as a crime if they had not been in retirement. "Elsewhere, I hope to be writing on the contribution these people are able to make to both the economic and social work of the world. To-day I will content myself with the barest outline and say that at the age of 60 a man should be relieved of the obligation of doing any duty at a particular time; particularly he should be relieved of the necessity of answering important questions right away. This, however, does not mean to say but what in his own time, and at his own speed, such a man is not capable of doing a very considerable amount of useful work.
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"To come from these general principles to the actual housing of these people I would like to say I do believe we should house them, as I know you agree, near centres of social and cultural activity so that at least they would feel they have the opportunity of engaging in such activity if they so wish. At the same time, their homes should be so placed that when they do want to stir abroad they have something to interest them, particularly in the way of trees and gardens, or even bird sanctuaries. I myself believe it is quite possible to have even a day nursery close to these homes for the aged, because Page 8 it is wonderful how the two extremes of life do get on together without the necessity of the old people having declined into what is commonly spoken of as their ' second childhood.' "I am afraid that if we are to have these houses near the centre of the town we must build more than one storey, and this raises the question of stairs; always a difficult problem.
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The stair treads must be deep enough for old people to be able to stand firmly on each stair, and the rises must be less than are commonly found in most houses built to-day. I do think there should be not more than five steps in any one flight, and then there should be a little landing where there is room for the person, not only to stand firmly on two feet, but to move about a little to get the feel of the feet. Incidentally, hand rails should be on both sides of the stairway, and there is something to be said for the stairway being narrow, so that a person can use both hand rails at the one time. We do not want to overdo this, however, because there may be occasions when people want to be helped up and down stairs.
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"So far as rooms themselves are concerned, what I believe to be the greatest thing is to be able to maintain a background temperature all the year round, and if this means we have to build a larger number of one-roomed flats then I think we shall have to face that problem, because on no account should these old people go out from the living-room, which is relatively warm, to a bedroom which is not warm. Exactly what this background heating should be for these old people I do not know, and I would like to talk it over with you, but I think it should be at least 65 deg. F. "Arising from this question of background heating, we come to ventilation. Quite frankly, if we have to limit the amount of ventilation in order to achieve this background heating we shall have to accept this as the necessary cost of providing the heating, and, anyhow, elderly people, so it would seem to me, do not require the same amount of ventilation in the rooms they occupy as younger people do.
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"The best height for the lavatory pedestal has, I believe, yet to be discovered. They must not be too low; contrariwise they should be rather on the high side. "The problem of the bathroom has its own difficulties. Old people should be encouraged to take baths, but only if it can be done safely. To this end we have to decide what is the maximum height Page 9 of the edge of the bath above the floor which is adjacent to the bath, and, quite frankly, I think it should not be more than 18 inches or so. There must be suitable hand rails so that old people can get in and out easily and safely, and there is something to be said for the baths in which people sit down rather than the baths in which people lie down.
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"The question of what form of cooking should be provided I think, is open to very much discussion; upon the one hand, gas can be quite dangerous; on the other hand, a large number of people are not acquainted with the use of electricity. I recognise that the problem is vexed, and there is plenty of room for different opinions, but on the whole I think that electric cooking is in all the circumstances the better of the two. "Old people have always sought medical help more than other age groups, and if we want to give them the widest choice of doctors we must make arrangements for the doctor to come and see them. To this end I am wondering whether it would not be wise to arrange for a doctor's surgery in a part of the building which is communal, or at least a room which could be used as such. It could be a dual-purpose room, as I am only thinking of the simplest form of surgery.
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I should say that a hand-basin would be all that is obligatory, and the room could also be used by welfare officers and other people who came, and I hope they will come to see old people rather than ask the old people to traipse about to find them. Incidentally, I can mention a hope of mine that whilst old people will be allowed the widest choice of their private doctor it will ultimately come about that for all practical purposes there will be a medical officer for this group of buildings, because only in this way could the work be done efficiently and economically within the present framework of the National Health Service Act. "Providing we get old people to retain a minimum of furniture the rooms should be so small as may be; the possibility of one room leading out of another, if this leads to shortening distances between A and B and back again, should be entertained. Incidentally, by having rooms leading out of one another we might be able to help solve the problem of background heating."