ids stringlengths 36 36 | texts stringlengths 1 1.43k |
|---|---|
024208aa-250c-4a76-92e1-84fe3eeb9315 | There was a gratifying response and our first meeting, on 1st July, 1953, was attended by the following:— Superintendent Health Visitor, Barking Health Area Senior Education Welfare Officer, Barking Committee for Education Rehousing Officer, Barking Borough Council Inspector Holmes, Barking with Dagenham Branch N.S.P.C.C Manager, Barking Office, National Assistance Board Children's Visitor, County Children's Department Probation Officer, Becontree Division Psychiatric Social Worker, Ilford Child Guidanr Clinice It was decided to hold regular monthly meetings and Iso to invite a duly authorised Officer from the County Mental Health Department It is not possible to assess the value of our meetings solely on the first six months experience, but I know that all concerne have found the personal contact with their colleagues in other depai ments of the utmost value. I think we can also claim that in some cases where two, three or more workers had been visiting we ha e prevented wasteful and irritating overlapping of services. |
641685f4-e62e-49d4-8be5-994c96ef8d5e | It was agreed in each. instance that only one worker would continue supervision, reporting back to the Committee when there appeared to be need for further action. The creation of such a committee does not, of course, enable us to provide help which is beyond the power or scope of its individual members and their respective departments or organisations, but the free discussion on possible lines of action has been most valuable in determining policy with regard to some families. Since "co-ordination" is the catchword of today, it might be of interest to remark upon certain inherent difficulties where bounds and catchment areas of the departments concerned differ widely. Page 24 Owing to the policy of the County Health Committee in decentralizing personal health services to correspond with borough boundaries, at least two of our members—the Superintendent Health Visitor and the Senior Education Welfare Officer—cover the same area, that of the Borough of Barking. |
0273bdbc-dfbe-41de-b485-9bc8724c4dbd | Strangely enough, the Rehousing Officer is only responsible for a portion of the Borough owing to the fact that the Becontree Housing Estate is managed by the London County Council. During 1953 the N.S.P.C.C. Inspector was responsible for Barking, most (but not all) of Dagenham, a part of West Ham and a part of East Ham. The local office of the National Assistance Board covers Barking and the southern portion of Ilford. The Children's Visitor works from an office which covers that part of the County lying in the Boroughs of Barking, Ilford and Dagenham, she herself being responsible for Barking together with a portion of Ilford. The Psychiatric Social Worker from the Child Guidance Clinic is likewise responsible for Barking and a part of Ilford. The Duly Authorised Officers work from an office in Romford which covers Ilford, Barking, Dagenham and Romford. |
77df2703-523a-426a-9e22-f145b2013fb8 | Three of these officers cover the boroughs of Ilford and Barking, and any one of these three might consequently deal with Barking cases. To complete the picture the Probation Officers are attached to the Becontree Division, their territory co iprising Walthamstow, Leyton, Ilford, Barking and Dagenham. THE AGED. It is well known that our population is "ageing," the result largely of a falling birth rate, a smaller proportion of children, and hence an ncreased prortion of older folk. The act ties of our public health service, however, have also played their: part since more people now live into "old age." Sanitary enginee. with provision of pure water supplies and sewage disposal schemes, has eliminated such scourges as typhoid fever and cholera. |
0c1e60b6-ff6d-4ece-ade8-767c1c489d2b | Our infant welfare services have reduced infant mortality to less than; fth of what it was some 50 years ago, whilst deaths Prom infectiou diseases other than tuberculosis are now rare. As a suit expectatn of life has increased markedly. A baby boy born in 1900 could expect to live on the average 44 years—whilst today his expectation of life is 66 years. For the "weaker" sex, the average life span has risen from 48 years to 71 years during the past half Century. Whilst many more people are living into old age, however, the old people liemselves are not living substantially longer. For Page 25 example, in 1900 a man of 65 could expect to live a further 11 years, whilst today his expectation of life is only another 12 years. Some of the results of the increasing proportion of old folks in our midst are all too familiar. |
0ccd9da8-ff6a-4dcf-8985-d376aa23e6a9 | We know of the great difficulty in finding hospital beds for the aged sick and of the great increase in demands on the home help service in recent years. Not only are there more old people needing care but they are more willing to accept it now that the stigma of the Poor Law has been removed. Smaller families and the tendency of children to seek employment away from their home town has left fewer close relatives in the vicinity of their ageing parents. Fortunately only a small proportion of our old folk are infirm or sick; however, and the majority maintain their health for than hitherto. This, together with other factors, has led to consideration of the desirability—both for the individual and the community—of continuing employment beyond the previously accepted retiring age, and there is a growing body of evidence to suggest that this actually helps to postpone the ageing process. Post-war legislation tacitly assumes that the aged can be meekly divided into three groups, the able-bodied, the infirm, and the chronic sick. |
65d5c680-f9d2-4872-825d-3b667b4f6644 | Unfortunately the old folk have the temerity not to allow themselves to be thus neatly pigeon-holed, and some even have he audacity to change from one category to another! For the able-bodied the Borough Council can provide houses, and I am pleased to record that you are making special provision on your new Thames View Housing Estate for these old people. If you wished, this accommodation could be grouped to form an hostel and you could also provide laundry facilities and a restaurant service which, I am sure you will agree, would be a boon to the less active. The Council also makes financial grants to the Old People's Welfare Committee, which is thereby enabled to make available recreational facilities for the aged (such as Old People's Clubs)and to provide schemes such as that of subsidized mid-day meals. The bodied also have the opportunity of using such facilities as those provided by the Health Area Sub-Committee in the foot clinics. |
7b8612b1-1045-4130-b2c2-9d7c61b50c81 | The aged infirm who can be cared for in their own homes are assisted by the home help service, and they receive supervision from the health visiting staff (both administered by the Health Area subCommittee). The "Meals-on-Wheels "service is provided by the old People's Welfare Committee, whilst if residential accommodation required this is the responsibility of the County Welfare Committee Page 26 who themselves have a separate staff' of visiting officers. If an old person refuses to accept an offer of residential accommodation despite the fact that he is living in insanitary circumstances and is not receiving due care and attention then it is the Borough Council, on my recommendation, which secures a court order for compulsory removal. One such case had to be dealt with under Section 47 of the National Assistance Act during the year—an old lady living by herself in an upstairs flat under grossly insanitary conditions and quite incapable of looking after herself. Although unwilling to leave home she settled down happily in St. George's Hospital and has remained there voluntarily. |
8c4a80dc-e209-4ab6-aac4-2432be7ca072 | I should like to record my appreciation of the assistance received from Mr. Fisher, Area Welfare Officer, in this case. The aged sick being nursed in their own homes, either through choice or lack of hospital beds, have available the services of the district nurses (administered from the Lady Rayleigh Training Home, Leytonstone by the Training Homes Sub-Committee of the County Health Committee), and Home Helps (Health Area Sub-Committee). The latter Committee also has power to provide a service of night attendants to relieve relatives in cases where the patient is restless at night, although it was not possible to inaugurate such a service during 1953. The Committee has also made an endeavour to provide a domiciliary chiropody service for patients confined to their beds or homes, although the Ministry of Health has unfortunately refused to sanction such extension to the service—allegedly on financial grounds. |
1422c23b-4d24-4301-ab26-b54bfd00dbb3 | Such patients are thus still brought to the clinics by ambulance (one presumes that this costs nothing, and that the ambulances have nothing better to do!) In a further effort to help relatives nursing incontinent patients at home, the Borough Council has inaugurated a laundry service using powers under Section 84 of the Public Health Act. This service, free to the patient, provides for the laundering of soiled articles such as sheets and night clothes at the Barking Hospital Laundry by arrangement with the Hospital Management Committee. Collections and deliveries are made three times per week. Since this service commenced, an average of five hundred articles per month have been dealt with and seven cases were being assisted at the end of the year. The help given to these families is invaluable. There has been the greatest difficulty in obtaining hospital beds for the elderly sick—even in cases of urgency. |
0955fa8e-470e-46d5-bea9-5eff812e4b05 | Within the Ilford and Barking group of hospitals there are only 22 chronic sick beds—all for women—at the Barking Hospital, and admissions are controlled by the Page 27 Surgical Registrar at the King George Hospital, Ilford! Most Barking patients have to be admitted to the St. George's Hospital, Hornchurch, which is administered by the Romford Group Hospital Management Committee, and admissions to which are controlled by the Medical Superintendent of the Oldchurch Hospital, Romford! In neither case does the physician in charge of the beds see the patients before admission in order to assess medical needs, and routine reports on social conditions are not requested, although we send health visitors' reports where home conditions are exceptionally bad. It is thus not surprising that on occasion we feel those with the greatest need of a bed are not necessarily admitted first. The position is aggravated by the fact that many hospital beds are blocked by patients who no longer require skilled nursing or medical attention but who cannot look after themselves. |
64639c01-55a9-4c63-995a-35202fedb987 | There are seldom vacancies in the County Welfare Department's hostels to which they can be transferred, and difficulties also arise where a patient considered too fit for hospital is classed as too infirm for a hostel! I have the feeling that many old people at present in hostels could have been kept at home had suitable facilities been available, and this aspect is one to which we must devote more attention in coming years. It involves the provision of special housing accommodation—ground floor, compact and easily managed—and routine visiting so that appropriate supporting services such as home helps and meals-onwheels can be brought in to assist before deterioration sets in. The elderly prefer to remain in the familiar surroundings of their own homes—let us do our best to keep them there whenever possible. LOCAL GOVERNMENT RE-ORGANISATION. The last major re-organisation of local government in this country was effected by the 1888 Act which created County Councils and County Borough Councils. |
55284c8f-876b-4005-9630-ec6bdbde7ed1 | This, you will recollect, was only a few years after your first Medical Officer of Health was appointed. Since then the services provided by local authorities have increased in nature and in scope out of all recognition, but the framework of local government has hardly altered. The 1929 Local Government Act concentrated certain powers into the hands of County Boroughs and County Councils, a process which has been taken a step further by post-war legislation. During 1953 the various local authority organisations have been giving detailed consideration to the problems involved, but their reports were not available by the end of the year and in any case it is not for me to comment on the problems of local government in general. Page 28 Scattered throughout this report, however, you will find reference to difficulties experienced in co-ordinating services provided by various statutory authorities and voluntary bodies with widely different boundaries and catchment areas and with functions which often overlap or fail to link up with each other. |
cb35a6ac-74e8-470c-be58-6f18a6d95915 | So far as the health services are concerned, I think there is much to be said for the functions of the existing local health and local sanitary authorities, local education authorities, the hospital management committees and local executive councils, all being administered by one elected body in one given area. In order that the services may be controlled locally, the district should contain a population not exceeding 250,000 and should, if possible, cover both urban and rural areas. (Unfortunately an impossibility in the conurbations.) Perhaps I should also make it quite clear that I am not suggesting that the Medical Officer of Health should necessarily be the senior administrative officer of such a comprehensive health authority, indeed, I think there is much to be said for freeing him for his most important functions—those of epidemiologist and health educator. Certain highly specialised hospital services would still have to be provided on a wider basis and elsewhere I have suggested that likewise ambulance services should be organised regionally. |
f12bb4fd-f5e9-47bb-9670-f81c2beda6a1 | These and other lunctions such as Town and Country Planning, Fire and Police services at present administered by County Councils could well be passed to a limited number of new Regional authorities—in some cases formed by a combination of smaller counties. I realise that proposals of such a nature will not find ready acceptance involving, as they do, the merger of some smaller authorities and the transfer back of certain functions from many "major" authorities. Nothing less than the radical will suffice to strengthen cur local government system however. Unless it is strengthened and rejuvenated still more services will inevitably be turned over to specially seated bodies of centrally appointed, rather than locally elected, members. Local Government will then cease to attract members and officers of the same high standards and abilities as hitherto and will wither away. Page 29 PERSONAL HEALTH SERVICES The National Health Service celebrated its fifth birthday during 953. |
8723a7f2-1603-4d67-9064-0f988655a38e | It is generally agreed that much has been achieved in these first five years, although there is an almost equally widespread feeling that improvements could be made in its administration and available monies spent to better advantage. This was recognised during the year by the setting up of the Guillebaud Committee, whose report will be eagerly awaited by those whose faith is that "prevention is not only better, but also cheaper, than cure." It may be of interest to consider certain of the services which you have built up in Barking mainly during the past quarter of a century and as we find them five years after the "appointed day." HOSPITAL SERVICES When my predecessor came to Barking in 1927 the infectious diseases hospital was housed in what I have had described to me as a "tin hut." his contained 40 beds for infectious cases and, in a separate portion of the building, 12 beds were available for maternity cases. |
eb1cdc8e-1c75-47e5-8e4a-1476ee421c03 | In 1931 the first portion of the new permanent infectious diseases hospital, known as Barking Hospital, was opened and in 1935 the second porton was completed. Before' the war this Hospital, with its complemen- of 108 beds, was substantially filled with patients suffering from such seases as diphtheria, scarlet fever and erysipelas. At the comme ement of hostilities all Barking people suffering from infectious diseases were sent to hospitals in other districts. So great has been th fall in the incidence of diphtheria and the severity of scarlet fever hat since the war there has been no need for special accommodatn to be provided in Barking for such diseases. |
950d3963-1a37-4ab6-97fc-3b1c562c8964 | It is impossible to Compute the enormous sums of money which must have been spent nationally years ago upon the hospital treatment of patients suffering from diphtheria, but I note from my predecessor's annual report for 1927 that a four months' stay in hospital for a diphtheria case was not at all uncommon. As an aid to the work of the Barking Hospitals, a small but well equipped laboratory was built and the high esteem this unit gained many years ago is still maintained. I note that in 1935 no less than 2.792 swabs were examined for diphtheria bacilli but such swabs are rarely taken now. This fact alone must mean that a significant proPortion of laboratory facilities are now available for other investigations. Page 31 A new permanent maternity pavilion—the Upney Pavilionproviding 24 beds was opened in 1936, and it was planned that this building should be duplicated to double the bed complement, but the outbreak of war prevented this development. |
bdb68020-1ebf-4cd3-b952-723abfbe37ec | At the end of the war the decision that the Barking Hospital should not revert to the reception of infectious disease cases led to accommodation becoming available for other purposes. Amongst other things it gave a happy solution to the problem of finding a new home, complete with X-ray facilities, for the Chest Clinic which for many years had been accommodated in very cramped quarters in a house in Linton Road. In addition Harvey and Sydenham Wards were taken into use for maternity and gynaecological cases. A small unit for chronically sick female patients has been opened in the Jenner Ward and Paget acts as an "overflow" for certain clinic services which cannot be fitted into the overloaded Upney Clinic. |
b73d78ac-0bff-4d0c-a69e-eb7eda10f534 | The Barking Hospital, together with the Upney Maternity Pavilion, came under the administrative control of the Ilford and Barking Group Hospital Management Committee of the North East Metropolitan Regional Hospital Board on the "appointed day," but my predecessor continued to hold the post of Medical Sup rintendent until his official retirement on 15th January, 1953. Whil t I do not pretend that it is necessary or even desirable for a speci ist in preventive medicine to spend too much of his time acting ac a hospital administrator, this appointment must have provided a .trong link between the hospital and the preventive services in the B rough. A measure of liaison with the Hospital Management Committee is secured by the fact that three members of the Council are also members of the Hospital Management Committee, whilst at officer level I have endeavoured to bridge the gap by working closely be h with the Secretary of the Hospital Management Committee and with the Senior Medical Officer at the Barking Hospital. |
448006cd-598a-40a8-a6d3-a227a0202690 | It is a pleasure to record my appreciation for their help and co-operation, which has een steadily building up during 1953. I am hopeful that the link will be strengthened during the forthcoming year by my membership of the Group Hospital Medical Advisory Committee. The need for co-operation between the various branches of the service is of particular importance in the case of the maternity and tuberculosis services and in the provisions for the welfare of the elderly, matters which are discussed in greater detail elsewhere in this report. Page 32 LOCAL HEALTH AUTHORITY SERVICES On the "appointed day "services which you had provided as a welfare authority under the Public Health Act were transferred to the Essex County Council, although the administration of certain of these services was decentralised to the Barking Health Area Sub-Committee for the purposes of day to day control. |
dda8ba22-b29f-4d4d-ae23-8ae25de7b309 | Of the 29 members of the Health Area Sub-Committee, 15 are members of the Borough Council, 7 (including the Chairman and ViceChairman of the County Health Committee ex officio) are appointed by the County Council, and of the remainder one is nominated by each of four voluntary associations and one by each of the Ilford and Barking Group Hospital Management Committee, the Local Executive Council and the Local Medical Committee. The meetings of this sub-committee are arranged to take place immediately preceding meetings of your Public Health Committee, thus helping to ensure the comprehensive consideration of all matters affecting tl health of the people of Barking on the same evening. The effort keep the environmental and personal health services in one functional unit is also reflected in my joint appointment as Medical Officer of I alth and Area Medical Officer, and by the fact that the Public Health Department and Health Area Office are administered as one—ne ssary financial adjustments being made between the authorities ncerned in respect of joint use of administrative staff. |
480008c2-8dc9-4956-aa31-ccd958537a8a | Despite this I think it true to say that you remain far from satisfied with these arrangements. I believe I should be right in assuming that your attitude was particularly well summarised in the following extract fron a recent leading article in The Times, dealing with local government and the need for re-organisation:— "This legalistic nonsense has forced the transfer of many essentially local and personal services to county councils, which are often too big and remote to conduct them in the right spirit and have frequently delegated them back for daily management to 'minor' authorities perfectly capable of assuming full responsibility." health centres On more nan one occasion my predecessor pointed out that certain Barking clinics are already designated as health centres under the National Health Service Act. Such designation was made largely to enable the public dental scheme to be continued by arrangement Page 33 page 34 with the newly formed Local Executive Council, and in the case of the Manor and Bifrons clinics these are health centres in name only. |
eb400a80-1e55-4226-b029-f2e695c1d0cd | A true health centre provides under one roof facilities for the patient to consult family doctor, health visitors, other members of the local authority team and, where necessary, hospital specialists. A consideration of the development of the services in Barking will show how near you came to this ideal prior to the introduction of the National Health Service. A quarter of a century ago there were three clinics at liarking— Alexandra, Greatfields and East Street, whilst a classroom at Faircross Special School was used for ultra-violet ray treatment. The Alexandra clinic, housed in a temporary building, had limited facilities and was used for infant welfare and ante-natal sessions until its demolition in 1939. Greatfields Clinic, in a more permane building, is still being used although likewise for maternity and cl id welfare services only. East Street was the major clinic of the town and provide services for mothers, infants, and school children, including dental treatment and specialist eye services. |
f77120e8-48f1-49d2-82d1-c250772304b9 | It is interesting to read that at that time "by instruction of the Board of Education, the following scale of charges has been made:— (a) Spectacles 2s. 9d. per pair (b) Tonsils and Adenoids operations 5s. per operation (c) X-ray treatment No charge (d) Minor Ailments Is. per 3 months, after 14 days free treatment (e) Dentistry 6d. per extraction, and ls fillings or w ing (f) Orthopaedic treatment No charge Free medical treatment will continue to be given where parents cannot afford to pay." Although most of these services were transferred frc a East Stree to the newly erected Central Clinic in 1934, the buildii gs have been used for one purpose and another ever since. Part was used for health visitors offices, and dental services continued in the remaining portion of the building until the onset of war. |
0911976e-7dc6-41d4-a89f-6dde783c6ec3 | It was then used to house the first public foot clinic until more spacious accommodation could be provided, since when it has been re-equipped as a dentai surgery. Following closely on the erection of Central Clinic, new buildswere opened in Woodward Road in 1935 to serve the rapidly expanding Becontree Estate, but your plans for a permanent clinic in the Porters Avenue area were thwarted by the onset of war. At the end of hostilities Central Clinic remain unscathed, but Woodward Clinic had been severely damaged by enemy action and a civil defence building had been grafted on to the remaining fabric of the original building. Of the other first aid civil defence posts built in the town, the one at Upney Hospital and the one in Porters Avenue were earmarked for incorporation in the post-war clinic service of the town, but only as a short term policy. |
a95a5fd7-6c4f-45c4-bb71-df6ef50678af | The Porters Avenue premises were eventually adapted for clinic premises according to the plans of the Borough Architect and despite the limitations imposed by the substantial fabric a well planned clinic building has been created, which will serve the area for some years to come. The orthopaedic and physiotherapy service had become very cramped in its home at Faircross School, and was re-housed in classrooms at lie Manor School. It is now hoped that this clinic, which provides all the facilities to be found in the out-patient department of a first lass hospital, will soon be transferred to more suitable accommodation in the Barking Hospital. The enormous growth of the dental service made it necessary to multiply the number of surgeries available and centres were opened up at the Bifrons and Manor Schools, whilst a dental laboratory was set up to lanufacture dentures and the appliances necessary for orthodontic treatment. The Commencement of the war had seen the virile growth of new services. |
97ac778b-2405-4cc1-9008-354c49c6e6de | For a number of years clinic services in the town had been accepted as an essential part of the provision for patients coming within the school health and the maternity and child welfare schemes, but their facilities were still denied to patients outside these two categories. A foot clinic had been started in 1938, and dental services were next made available to adults. In the policy of bringing services to the people's doorstep, the consultant specialist schemes were next expanded to include all Barking residents who became entitled to attend Consultant skin, Orthopaedic, Ophthalmic and Ear, Nose and Throat clinics. Moreover, every effort was made to ensure that where obligatory the smallest possible charge was made to the public using such services. Neither must it be forgotten that for 11 years prior to the introduction of the new Health Service you had been operating a scheme whereby mothers and children attending your clinics could be given Prescriptions for medicines which were dispensed free to the patient by arrangement with local chemists—a power which has now been lost. |
819d1a16-cb2b-48a9-b1fc-c367f2f80266 | Page 35 It will thus be seen that prior to the "appointed day" it only remained to make family doctor services available to adult males and the elderly for the clinics to have become health centres in the fullest sense. It now appears unlikely that new health centres will ever be built on the scale envisaged when the National Health Service Bill was under consideration, and preparation of the County Development Plan during the year has caused further consideration of long term policy. It was originally planned to have five health centres, each conveniently situated in the neighbourhood unit to be served, but owing to the decision that such neighbourhood units should cater for a population of 20,000 instead of the 15,000 previously envisaged Barking was "rationed " to four health centres. The area comprising the Becontree Estate north of the District Railway and a similar area to the south still form obvious units. |
d242d1ef-8b4f-4e04-9c78-d38940855b0d | For the Becontree north area it had been hoped to reserve a site in Cannington Road but unfortunately this was earmarked exclusively for educational purposes in the County Development Plan, and you have somewhat reluctantly decided to accept an alternative site in the Mayesbrook Park adjacent to the proposed community centre. This is situated at the very periphery of the unit and across busy Lodge Avenue, and when the time comes you may wish to consider the possibility of a multi-story building on the site of the existing Porters Aven e clinic. The originally suggested site on Castle Green remains to serve Becontree South, and here it may later be possible to incorporate a day nursery to replace the existing Gale Street Nursery. The older end of the Town was to have been served by a centre on the St. Paul's Church site but since this was allocate for other purposes you decided to earmark a site in the vicinity of proposed New Town Hall and the area of Central redevelopment. |
48d540e4-d69c-42b4-8817-8a03809cc701 | this centre is not likely to be needed for many years to come, and in view of the excellent condition of the existing Central Clinic you may later decide simply to extend the present building and build a new wi to accommodate the dental surgeries still at East Street, the Centra Foot Cliniv and the Dental Workshop. For the fourth centre the Rosslyn Road site provisionally marked on the draft Development Plan has been abandoned and the Health Area Sub-Committee has adopted my suggestion of a site within the Page 36 CLINIC SERVICES IN BARKING Area Served Clinic Services Provided Western end of Town ("Old" Barking) + Central Ante-Natal Infant Welfare Immunisation Dental Minor Ailments øEar, |
993629a9-e749-4742-95c9-fdb2c58d6764 | Nose and Throat øOpthalmic (including squint Chiropody training) Chiropody East Street Dental Greatfields Ante-Natal Infant Welfare Manor a nd Eastbury Estates Upney Ante-Natal øObstretic øGynaecological Post-Natal Infant Welfare øPaediatric Immunisation Minor Ailments Paget Ward (Barking Hospital) Birth Control øSkin Speech Therapy + Manor Dental øOrthopaedic (including Physiotherapy) Becontre North + Porters Avenue Ante-Natal Infant Welfare Immunisation Dental Minor Ailments øOphthalmic Chiropody + Bifrons Dental Becontree South + Woodward Ante-Natal Infant Welfare Immunisation Dental Minor Ailments øOphthalmic Chiropody + Designated as Health Centres for Dental Purposes. ø Consultant Specialist Servirp. Page 37 grounds of the Barking Hospital, where there will be an ideal opportunity to develop even closer contacts with the hospital and specialist services. |
e7da3e49-ea7a-4f11-bec9-cf4c0ad1d32e | I believe this idea closely resembles a pre-war concept of a "polyclinic" which would form your main health centre and accommodate all those specialist services which could not be provided in each of the other centres. I hope that it will soon be possible to make a modest start on this project by rebuilding the existing Upney Clinic on the health centre site, instead of spending the money on alterations and additions to the existing clinic which had originally been approved for the 1950/51 Capital Building Programme. The draft County Development Plan provided for a health centre on your new Thames View Housing Estate, but since the ultimate population of this Estate was not expected to exceed 7,000 it would clearly have been inappropriate to allocate one of your four major health centres to this area. Provision is being made for clinic premises to be situated in the centre of the Estate close to the shoppin area and adjacent to the schools. |
8e512ef2-d547-4d16-9287-d0a42565f727 | The Local Executive Council has been offered accommodation in this clinic for general practitioner services, and we shall all eagerly await the outcome of this approach. Much has been talked for the need for co-operation between the general practitioner and the local health services. In my view this is a golden opportunity to develop the health centre concept with local authority health visiting nursing and secretarial staff to assist the family doctor in his practice, and the general practitioner carrying out for his own patients ir mach of the work traditionally performed by local authority medical officers I sincerely hope that the opportunity will not be missed for it will not present itself again. |
87620209-7c85-4038-982b-72264f9c7c0c | CARE OF MOTHERS AND YOUNG CHILDRE> MATERNITY SERVICE The National Health Service Act has created a split in idministrative responsibility for the maternity services, control of the Upne) Maternity Pavilion having passed to the Ilford and Ba; ing Group Hospital Management Committee whilst it is now the fui > tion of the County Council to provide ante-natal and post-natal ci tics, and a domiciliary midwifery service. The local Executive Council also conies into the picture in cases where the mother-to-be chooses to receive care from her own doctor or from a general practitioner obstetrician The position is further complicated by the fact that a family doc|pr called in to the home to deal with an emergency receives a fee from Page 38 Local Health Authority if a midwife has sent for him, but is paid by the Local Executive Council if relatives call him in! Ante-Natal Care. |
b9224dc6-5725-44a7-b7bc-c019c48a4fe3 | Reference has already been made to the good use made of your powers under the 1918 Maternity and Child Welfare Act in the building of the Upney Maternity Hospital, and it will have been apparent that from the earliest days you had a highly developed system of ante-natal clinics for mothers booked for confinement at Upney or in their own homes. The typical Barking approach is shown in the following extract from the report of the Medical Officer of Health for 1927:— "A new development towards the end of the year at the ante-natal clinic was the attendance of one of the health visitors at one session weekly for the purpose of giving advice and instruction in ante-natal hygiene and other appropriate subjects." |
a0475c2d-0c2e-4656-8afe-6d21a835d733 | As long ago as a quarter of a century it was realised that the education of the expectant mother in matters relating to her own health during pregnancy and in the care of the coming baby was even more important than the ection of any obstretic abnormalities, vital though this may be n recent years the health visitors have further developed the educative side to their ante work by the introduction of classes in the art of relaxation. Mothers who have mastered the technique invariably have a shorter and easier delivery, and this is already being reflected in the increasing proportion of those who decline the help of gas and air analgesia. I hope that ultimately it will also have its effect in reducing still-birth and neonatal death rates. In 1927 less than half the Barking mothers received ante-natal care in your clinics. Some may have been seen by private doctors but it is probable that many were without this important supervision. |
d2e5995e-3696-4db3-b25c-1e3bcff7217b | By patient work the position has been steadily improved until the present day when some 90% of expectant mothers receive ante-natal care in 'he clinics, the remainder being under the care of hospitals or their own family doctors. Out of a total of 1,110 mothers confined in 1953 onlyone failed to receive any ante-natal care, this patient being Page 39 ANTE-NATAL CLINICS Number attending for first time 1,402 Total number of attendances 12,600 married and not notifying her condition until the day before labour took place. Arrangements have been maintained whereby mothers booked for Upney Hospital attend their local clinics to receive ante-natal care, thus ensuring continued supervision by the health visitors and other local authority staff to whom she will look for advice after she has been discharged from hospital. The hospital medical officers, who will have the responsibility for caring for the mothers during labour, attend the clinics in order to see the expectant mothers later in pregnancy thus saving the mother unnecessary visits to hospital. |
cc6e3217-3602-45bd-bc44-f145b2c9572c | The system whereby all ante-natal records are kept in the Upney Hospital overnight ensures that these records will be available if a mother goes into labour during the night, and is of especial benefit if she has to be admitted in an emergency. Confinements. In 1927 less than a quarter of the deliveries took place in hospital. Figure 6 illustrates how during the early years of the developing Becontree Estate the total number of births steadily rose without much alteration in the proportion of hospital and domiciliary confinements. From 1933 onwards, however, there has been a steady upward trend in the proportion of babies born in hospital —curbed only temporarily in 1946 and 1947 by the high birth rates in those years. This trend was made possible by the provision of the Upney Pavilion, later by the wartime evacuation arrangements and finally by the opening of two further wards for maternity cases. |
8440f6c5-97bc-4033-97c2-6bbd3cab766e | It has probably been re-enforced by the introduction of the National Health Service which made it much cheaper for the mother to have a baby in hospital, where domestic help, food and laundry are provided free of charge. The introduction during the year of the new home confinement grant of £3 goes some way to meet this difficulty, but financially the scales are still weighted far too heavily in favour of the mother who goes into hospital. Either the mother who remains at home should have all ancillary services free of charge, or the mother going into hospital should pay towards her keep. There is no doubt that at one time there were insufficient beds lor maternity cases, but today with 80% of Barking mothers being confined in hospital, one wonders whether the pendulum has swung too farIt is essential to provide hospital beds for those cases where any difficulty may be expected. It is equally necessary to provide for those mothers who do not have adequate accommodation for a home confinement. |
a3fdef2f-cdd3-430d-8e7d-254ca20c84c4 | It is questionable, however, whether beds should be provided for those who do not fall into either of these categories whilst Page 40 Page 41 DISTRIBUTION OF CONFINEMENTS 1928-1953 the national economic position renders it impossible to make adequate provision for certain other classes of patients such as the chronic sick and the mentally ill. A higher proportion of home confinements would help to stress the fact that childbirth is a physiological process, and also that it is a family affair. I feel that we tend to overlook the important part the father should play both during the confinement and the puerperium, Surely at this supreme moment a woman needs her husband more than at any other, and with his support would have an easier delivery and would more readily establish breast feeding. Maternal Mortality. No maternal deaths occurred during the year, although a death late in December, 1952, was not registered until early January and thus appears in the Registrar General's figures for 1953. Post-Natal Care. |
8e739be5-b79b-4345-8e1d-70fb2a5b1068 | In 1927 only 26 mothers were examined following their confinements and this figure remained low for many years, despite the repeated plea of my predecessor. POST NATAL CLINIC Number attending for first time 1,016 Total number of attendances 1,244 Whilst there has been a steady improvement so that in 1953 approximately 70% of Barking mothers received a post- natal examination, the position is still far from satisfactory. It cannlot be too strongly stressed that a post-natal examination is every bit as important to the mother as ante-natal care. We must not be satisfied until every Barking mother receives this examination about 6 weeks following her confinement. Gynaecological Clinic. The Specialist Gynaecolo; teal Clime, started by the Borough Council in 1933, is still held weekly at the Upney Clinic, and is now attended by Mr. B. G. Spiers, F.R.C.S. |
2a6a6109-386f-4ac0-a02d-9f4212d53cad | GYNÆCOLOGICAL CLINIC Number attending for first time 328 Total number of attendances 1,522 of the conditions treated there could have been prevented had adequate post-natal attention been obtained at the proper time Page 42 Dental Care. The services of the Dental Officers are available to the "priority groups" of expectant and nursing mothers and young children. During the year the Oral Hygienist commenced a series of talks to mothers attending ante-natal classes, an innovation to be encouraged since it is only by education of mothers in the care of their own and their children's teeth that we can prevent needless decay and unnecessary extractions. Too many mothers still refuse to let us fill their children's milk teeth and say "they might just as well come out," not realising that this early loss may cause the second teeth to come through crooked, and lead to months or years of orthodontic treatment to get them straight again. |
5fa666b4-9be9-4162-a1c1-b348b05e8adf | infant welfare Infant welfare clinics have also been provided in Barking from the earliest days of the service, the first having been set up in 1908. The results are reflected in the infant mortality rate, at that time 117 per 1,000 live births, which steadily fell to a figure of 66 a quarter of a century ago, and which stands at 26 for 1953. Despite the assertion in the report of the Medical Officer of Health for 1931 that "many people are igreed that it will be impossible to reduce the infant mortality rate to less than 30 per thousand births," the rate has in fact been below 30 for the past 6 years, as will be seen by reference to Figure 7. In some countries (South Australia for instance) the infant mortality rate 1 is already been reduced to 20 per 1,000 live births and there would appear to be no insuperable obstacle to achieving similar or even better esults in this country also. |
e8b9733b-c3fd-4f97-94d6-7c7521075c2d | The task is steadily becoming more diffii It as the mortality falls since most infant deaths now occur in th first weeks of life, the majority whilst mother and babe are still in ospital. We must, therefore, attack the problem more through ou ante-natal and maternity services, and for this we need more know.edge of the true causes of these deaths occurring soon after birth. Paradoxically, the success of the infant welfare movement has led to much criticism and even to the suggestion that infant welfare clinicsare no longer needed. Whilst I should strongly refute any such suggestion I do think it opportune to pause to reflect on the effects 0f earlier successes. The problems today are not those of 25 years ago, yet it may be fairly said that some of our methods have not changed nuch during that time. We must not become complacent, but adjust our ideas to the new problems before us. |
927d84af-113f-4e3a-96bf-6eb728a284d4 | "Summer diarrhoea" and rickts are now virtually non-existent, and clinics whose main functions are the distribution of dried milk and vitamins have no place in our Page 43 Page 44 COMPARATIVE INFANT MORTALITY RATES 1929 - 1953 service today. Too frequent routine weighing of an obviously healthy baby can do much harm to an over-anxious mother. Much attention is now being directed to the mental health of the nation. Many mental disorders can be traced back to mishandling in early childhood—and here too much "kindness" can be as harmful as too little. I am sure that a very important part of the work of the infant welfare service of the future will be the promotion of sound emotional development by means of the instruction of parents and parents-to-be in the art of handling their children. |
838a97a0-ea2e-4122-a44a-b3902d2a1e12 | INFANT WELFARE CLINICS Number of children—First Attendances in Year :— Under 1 year 1,047 Over 1 year 2,385 Total number of attendances of children:— Under 1 year 17,703 Over 1 year 11,016 whilst you have developed excellent services for expectant mothers and for babies, there has been a tendency to neglect the routine supervision of thoddlers in the vital years before they come under the wings of the School Health Service. If it is desirable to examine school children every two or three years then it is essential to arrange and annual routinie medical inspection of every toddler, and I hope to devote some attention to this problem in the ensuing year. A most v iluable service was introduced in 1945 by the appointment of a Children's Specialist who, although now employed by the Regional Hospital Board, continues to attend the Upney Clinic once per fortnight. The Consultant Paediatrician is Dr. |
d5824f2f-bcea-4c08-a7db-24803421be86 | S. B. Dimson, M.D. Page 45 PÆDIATRIC CLINIC Attendances :— School Children 258 Toddlers 141 DAY NURSERIES Your day nursery service was originated during the war years to look after children whose mothers were contributing to the war effort, but was developed and maintained to care for those whose mothers were unmarried, widowed or otherwise forced by financial circumstances to go out to work. The premises of Eastbury House and Lodge Farm were taken over in 1942, and a prefabricated building was erected at Gale Street in 1943. On the "appointed day" plans were well in hand for taking over the old Castle School as a fourth day nursery, and Rippleside was opened in 1950. At the beginning of 1953 the four day nurseries were full and there were 134 children on the waiting lists for admission. |
26ca2de5-d135-43ad-85d0-8f76681fac4d | By the end of the year, however, attendances and the demand for places had fallen so precipitately that we were forced to recommend DAY NURSERIES - DEMAND FOR PLACES JULY 1952-DECEMBER 1955 Figure 8 the closure of Lodge Farm and you were not unaware that it might be necessary to close a second nursery. As will be seen from Figure the falling off in demand for this service coincided with the imposition by the County Council in January of a greatly increased scale o charges, with a maximum of 7s. 6d. against your old standard charge of 2s. per day. You have held the opinion that this increase in charges has been directly responsible for this position, although it is to remembered that a similar position has arisen over most of the country Page 46 and that in general the numbers of children in attendance at nurseries had begun to fall quite steeply well before increased charges came into effect. Nursery and Child Minders Regulation Act. |
3efb5f65-4961-4097-81ca-7a8076e0ea70 | No doubt largely owing to the excellent day nursery service which you built up there has never been a large demand for registration under this Act. In 1953 two women were registered as Child Minders. Only one took advantage of this registration and had two children in her carc for part of the year. MIDWIFERY For many years domiciliary services in Barking were provided by midwives from the Plaistow Maternity Hospital and by midwives practising privately. As the Becontree Estate developed arrangements were made with the Salvation Army for their midwives to cover part of the Porter Avenue district, and you took midwives into your direct employment to serve the remaining areas. The Salvation Army terminated their agreement in 1947, and the Plaistow midwives withdrew on the apppointed day." |
7180b733-752a-4bf6-932a-b34d71ed7711 | Those municipal midwives who had been engaged to serve the Upney and Becontree areas were transferred to the control of the Barking Health Area Sub-Committee, whilst the area of "old" Barking was taken over by midwives from the County Training I me at Leytonstone working from the Longbridge Road Home. It ems a pity that at a time of radical change the opportunity was missei. f unifying the domiciliary midwifery services in Barking. I havt already made reference to the fact that a percentage of domiciliary jnfinements has been steadily falling over the last 20 years, and that t! trend will not easily be reversed. The National Health Service Ac as given the family doctors an inducement to undertake more midv ery work, thus tending further to reduce the midwife's responsibi! |
61355ec1-fea6-4302-96ba-a22b0dfff1e1 | s. We may be approaching the point where our midwives will not be aling with sufficient cases to maintain the high degree of competence lied for, a problem which will be accentuated in Barking by the divid control of the domiciliary service. I am attracted by the idea of a combined hospital and home midwifery se ice. This suggestion should not be entirely novel to you since a number of your domiciliary midwives spent an aggregate of about 4 year: . the "evacuation" hospital at Radlett during the war, and a Barking Hospital midwife later undertook domiciliary work to help over the difficult position created by the withdrawal of the Salvation ArmY midwives. Such a solution, whilst easy in the days when you Page 47 were a "Welfare Authority," could not so readily be achieved now that responsibility for maternity services is split between the Regional Hospital Board and the County Council. |
0cf7a6d3-b969-4e33-9197-7e8149c1384d | HEALTH VISITING The first "Lady Health Inspector" in Barking was appointed in 1907, and by the time my predecessor took office 25 years ago your staff consisted of three health visitors, two school nurses and one dental nurse. With the rapid expansion of the Borough and of the standard of service provided the establishment was further increased. Today it includes 12 health visitors (who combine their duties with those of school nurse), 4 dental nurses and attendants, and 18 part-time clinic nurses who relieve the health visitors of routine duties in the clinics. The introduction of the National Health Service Act has led to great changes in the duties and responsibilities of health visitors. Previously their duties lay primarily with mothers, young babies and school children, whilst they were also responsible for the supervision of children under the Child Life Protection Enactments. The latter duties were transferred to newly created Children's Officers by the children Act, 1948, a change which health visitors regard for the worse. |
00cbaad4-fc24-46b3-9e52-1d24998a6764 | The National Health Service Act, however, broadened the responsibilities of the health visitor to include all members of the family. This has focussed attention on the need for close co-operation with general practitjners who themselves, for the first time, became able to deal with the damily as a whole. Slow but steady progress has been made in this rirection to which reference is made elsewhere. It is also pleasant to record that co-operation with hospitals has improved likewise. Many more references and enquiries are now received from hospit. almoners, and we receive much more information concerning the discharge from hospital of patients requiring after-care, so that the health visitors now devote more time to hospital follow-up work. |
563c0be6-1eec-480f-9e90-5e45dc74721e | on the whole attendances at clinics have tended to fall following the ntroduction of the National Health Service, but since those most in need of advice are often those who never attended clinics in the past, or those who through age or infirmity cannot do so, it can only be to the good if health visitors have available more time in which to carry out home visits. After five years the position of the Health Visitor in he National Health Service is still far from settled. There has been an unfortunate tendency to multiply the number of visitors going into the home (e.g. newly created children's visitors, welfare visitors) and it is my belief that the Health Visitor should become the " general practitioner" Page 48 of the medico-social services, calling in specialist social workers as and when required. Her main job, like that of all members of the Public Health services, is to prevent illness and to promote health. |
e77e2353-90ab-466a-8165-c3ec670d8bf4 | In all her activities she must aim to educate, first in the need for action, and then in the methods of achieving the objective. HOME NURSING In the area of "old" Barking services of home nurses were also provided by arrangement with the Plaistow Maternity Hospital and District Nurses' Home, who received financial aid from the Council. In 1934 the East Barking District Nursing Association was formed on a voluntary basis to provide a district nursing service for the new Becontree Estate and this association also ultimately received your financial support. My predecessor was a member of the Committee of the Plaistow Maternity Hospital and District Nursing Association and was also Honorary Medical Officer to the East Barking District Nursing Association, so that he had a measure of control over the work of the district nurses throughout the area. |
2271f909-7635-4f0b-99e6-40882880e206 | Since the "appointed day," however, when these services were taken over by the County Council, they have been administered from the County's training home at Leytonstone and your Medical Officer lost contact with this service. It seems to me that the health visiting, domiciliary midwifery, home nursing and home help services are all integral parts of the domiciliary health services, and that proper co-ordination cannot be achieved unless they all come within the day to day control of the Health Area Sub-Committee. In fact the County's arrangements for decentralisation expressly provide that this service shall be administered by health area sub-committees, and it seems to me unfortunate that this principle was not implemented. VACCINATION AND IMMUNISATION Smallpox Vaccination. Prior to the "appointed day" vaccinations in Banking were carried out by public vaccinators and returns were forwarded to the County Health Department, so that figures are not readily available for vaccinations carried out before 1948. |
c4480f33-64dd-44e9-89f4-1dcec4eb2c9d | The County Council's proposals under Section 26 of the National Health Service Act envisaged that vaccinations would be undertaken mainly by general medical practitioners and supplemented by special sessions in the clinics only if circumstances called for such an extension. Page 49 Page 50 The figures for vaccinations performed under these arrangements show that in the first years of the National Health Service only one out of every 5 or 6 babies was vaccinated during the first year of life (see Figure 9). Assuming that we receive notification of all vaccinations carried out (and this seems reasonable since the doctor receives 5s. for each completed record card) there would appear to be good reason to provide facilities for vaccination at each of the infant welfare clinics so that this simple procedure can be performed as a routine in the early weeks of life. Diphtheria Immunisation. Immunisation against diphtheria was commenced in Barking in 1933, when eight children completed a course of injections. |
8483c82a-558d-45e4-9dd7-1cbe1c2f3a30 | Apart from a slight setback during the first year of the war, the number of children immunised each year rose rapidly to a peak of over 2,000 in 1943. The numbers of cases of diphtheria notified have fallen steadily since the peak number of cases reached in 1933, the last case having been notified in 1950. The fall in incidence had commenced by the time immunisation was started and whilst there have undoubtedly been other factors at work, reference to Figure 10 clearly shows how the incidence of diphtheria progressively diminished as the immunisation programme got under way. Our relative freedom from diphtheria means that young parents now have little first hand knowledge of the horrors of this disease, and there i danger that in consequence they will neglect to have their children protected. Protection given by immunisation in infancy must be maintained by a minimum of one " booster " dose when the child commences school. Whoop Cough Immunisation. |
aa56aa9e-0d44-41f8-a589-c7f3485b99b8 | Your scheme for whooping cough immunisation was introduced during 1941, and in 1946 a combined vaccine was made available so that babies could be immunised against both whooping cough and diphtheria with one series of injections. The scheme for combined immunisation was continued after the "appointed day" but during 1953 the County Council decided that this should longer be made available and that children should receive separate courses of injections against whooping cough and diphtheria. It was agreed, however, that we could continue to use "combined" vaccines for the purpose of investigating the relative merits of the two methods of immunisation, and I hope to report on this research next year. The work is largely being undertaken by Dr. Spiller. Page 51 AMBULANCE SERVICE Reading through the first Annual Report of my predecessor I was interested to read that " a motor ambulance is now provided for the removal of infectious cases to the Isolation Hospital, Upney Lane." (Italics are mine.) |
1135e8cc-a3e4-4964-8c2d-f2a4a68f8012 | This led me to turn up the report of the Medical Officer of Health for 1926 in which it is recorded that a horse ambulance was provided for the removal of such cases to the Isolation Hospital ! At that time accident and non-infectious cases were dealt with by ambulances coming under the control of the Chief Fire Officer. A fleet of modern motor ambulances was gradually built up, and in 1943 the service was made available to the public without charge. In 1948 the ambulance service was transferred to the County Council and the control of this service was not decentralised to Health Area Sub-Committees. This is a matter which personally causes me no regrets since I feel that to achieve maximum efficiency and economy the service must be based on as wide an area as possible. Ambulances are used almost exclusively for the transport of patients to and from hospital, and local health authorities have virtually no control over the demands for this service. |
93b2a2a9-7eb5-4e98-b5da-8ce971d20bce | Bearing in mind that it absorbs 28% of the authorities' expenditure, and that the service can in no way be called preventive, it is my feeling that it would more properly have been made the responsibility of Regional Hospital Boards. PREVENTION OF ILLNESS, CARE AND AFTER-CARE Prevention. The National Health Service was set up "to secure improvement in the physical and mental health of the people," and for "the prevention, diagnosis and treatment of illness." Prevention is, or should be, the main function of the local health authorities, and although the word " prevention " does not appear again until Section 28 of the Act, it will be obvious that many of the services such as provision for the care of mothers and young children, health visiting and vaccination and immunisation have a strong preventive bias. |
980821f4-3e5a-4269-a8ef-71de4b89802b | It is interesting to compare the money spent on the hospital general practitioner, and local health authority services and as will be seen from Figure 11 the lion's share goes to the Regional Hospital Boards leaving only 8 per cent. to the local health authorities. The breakdown of local health authority expenditure (Figure 12) shows that no less than 28 per cent. goes on the provision of ambulances— a service which I have already referred to as being one which would more properly fall to the Regional Hospital Boards. Provision of midwives, home nurses and domestic helps together account for a further 28 per cent. which amount might be more properly grouped Page 52 Page 53 with the domiciliary treatment facilities provided by the Local Executive Council. What may be termed the preventive services proper account for as little as 31 per cent. of local health authority expenditure. To prevent illness it is necessary to know much about its causation, but this is only a first step. |
ccdfd7bc-6fb9-4b6b-acd4-06aa7d16b61c | The discoveries of doctors and scientists working in laboratories, hospitals, and in the community at large must be translated into action by the individual. Before people will act they must be convinced of the necessity for action. This conviction can only arise from the efforts of our staff in the field of health education, and I hope to devote more attention to this topic next year. In the meantime it will suffice to say that I believe much of the so called health education consisting of distribution of pamphlets, the displaying of posters, and the giving of formal lectures, to be wholly inadequate for the tremendous tasks before us. Care and After-Care. Convalescent holidays, provided by the Borough Council for mothers and young children, were made available to all in need of them following the introduction of the National Health Service Act. During 1953, 39 cases were sent away for periods averaging two weeks. |
ee0a4585-13ab-4c82-b1ba-e1c4d72a935a | The loan of sick-room equipment, previously undertaken by the nursing associations receiving financial support from the Council and by voluntary bodies, is now dealt with directly from the Health Area Office. The following articles are available on loan :— Air-rings Back-rests Bed-blocks Bed-pans Bed-cradles Commode-chairs Cushions—latex foam Rubber-sheeting Tables (bedside) Urinals Wheel-chairs Walking sticks Demands for wheel chairs are heavy in the summer months and there was always a waiting list despite the addition of ten chairs to our stock. Mention has already been made of the chiropody service started by you in 1938. The foot clinics have been maintained since the CHIROPODY SERVICE Attendances : School Children 1,007 Adults 22,797 "appointed day," but it has not been possible to extend the scheme to provide treatment in the homes of those confined to bed, owing to Page 54 the refusal of the Minister of Health to sanction any expansion what soever. |
b6d4f132-9fab-4ed6-941b-f46f1db76b9a | To many, this appears a short-sighted policy since a small expenditure on foot care for elderly people may well reduce the numbers of those who eventually need the scarce and expensive places in hostels or hospitals for the chronic sick. The lack of beds for even seriously ill aged sick persons means that many have to be cared for at home with inadequate resources and at the cost of almost intolerable strain on relatives. During the year the County Council gave authority for a scheme to provide "night attendants" to sit up with such patients and thus give relatives some respite, but it was not found possible to find suitable volunteers for these arduous duties at the standard rate of 7s 6d.. per night. I expect to report more favourably next year, however. Mention has been made earlier of the Borough Council's laundry scheme for incontinent chronic sick, another service which has proved a boon to relatives caring for such patients. |
2eb69202-5399-4f42-8c9f-831b5b02baeb | Since he "appointed day" the County's tuberculosis services have been decentralised to Health Area Sub-Committees, and today include the provision of extra nourishment (1 pint of milk per day), loan of garden shelters, boarding out of child contacts, and rehabilitation at such Village Settlements as Enham-Alamein (Andover) and Papworth (Nr. Cambridge) and the British Legion Village at Maidstone. You also share with Dagenham the services of an occupational therapist who goes into the homes of cases confined to bed to provide valuable remedial and diversional handicrafts. The therapist works in close liaison with the Chest Physician and only undertakes cases with his approval. Valuable help is also given to tubercular patients by the Barking Tuberculosis After Care Committee. This Committee is a voluntary organisation which, in addition to raising funds by its own efforts, receives a grant from the Essex County Council. |
c4b522f3-0b27-42e9-af74-db9479a6025c | domestic help service The Domestic Help Service in Barking was originated by the Borough Council in 1943 when three part-time helps were appointed to attend home confinement cases. The following year the scheme was extended to cover illnesses of expectant and nursing mothers and children under 5 years of age, and demands on this service were such that for a period of about 2 years you paid private helps to attend cases where the Council's home help was not available. During 1946 the first full-time home helps were appointed and in the following Page 55 year the panel was large enough for you to dispense with the services of private helps. By 1948 the service had expanded far enough to justify the appointment of a domestic help organiser—these duties having previously been undertaken by the Matron of the Barking Hospital. |
d795d76a-24e4-4fa2-8e92-661af828570e | Year Number of Helps Employed Number of Cases Helped Total Hours Worked 1943 3 8 1944 3 32 1945 6 69 1946 12 261 1947 31 415 1948 36 303 1949 65 344 1950 55 387 80,699 1951 49 327 70,611 1952 84 318 85,743 1953 89 384 105,121 Whilst the number of cases helped has not materially increased since the introduction of the National Health Service Act there has been a great increase in the hours of help given, a total of 100,000 hours having been reached for the first time this year. The number of helps employed has been more than doubled since the "appointed day." This increase is due largely to the steadily rising numbers of aged persons to be cared for. |
b86587ad-31d6-4ddd-9ec4-4b92d8aa9bdc | Whilst in a few cases hospitalisation is really required in the best interests of the patient, in many other cases the assistance given renders it unnecessary for the old folk to be admitted to hostels or similar institutions and enables them to remain, as they would wish, in their own homes. GENERAL PRACTITIONER SERVICES. Prior to the "appointed day," the National Health Insurance Scheme provided free general practitioner services only for the bread winner of the family, whilst local authorities provided much of the Page 56 medical care for mothers and young children. In 1948 these services were extended in both directions. The general practitioner was, for the first time, enabled to provide free medical attention for all members of the family, whilst the duties of the local health authority, through its Health Visitors, expanded to embrace not only mothers and children but working adolescents, adults and the aged. There was, therefore, a danger of some overlapping of functions which accentuated the necessity for close co-operation between the general practitioner and the local authority services. |
1e8d67c6-b073-4915-8ae5-496e94277d03 | In an "all purpose" authority, the area served by the Local Executive Council corresponds to the Borough boundaries and the Medical Officer of Health is usually a member both of the Executive Council nd of its Local Medical Committee. In a two-tiered system where the Local Executive Council covers the whole County this is not practicable and many opportunities of co-ordination are thereby lost. In Barking the activities of the British Medical Association do not provide a suitable substitute—once again boundaries providing a stumbling block. The Stratford Division of the Association covers the County Boroughs of East and West Ham and the Borough of Ilford together with most, but not all, of Barking, certain practitioners working at the Becontree end of the Borough belonging to the South East Ess Division. I am hopeful that the Barking Medical Society will soon resume its activities and, inter alia, provide valuable contact between general practitioners and myself. |
10a5ff18-0664-4d50-8eaf-e198b17cd822 | I am certain that we are moving steadily away from the suspicions of the pre-1948 era when it was felt that your extensive services were in competition with the private doctors, and it is with the greatest pleasure that I acknowledge the help afforded me personally by many individual doctors in 1953. True co-operation, however, can only result from personal contact between general practitioner and health visitor and a close understanding of their respective functions. To further this, arrangements were in hand at the end of the year for meetings at each of the clinics to which family doctors working in the area will be invited to give them the opportunity of meeting the health visitors and other members of the local authority team. Page 57 REPORT OF THE CHIEF SANITARY INSPECTOR FOR THE YEAR 1953. STAFF. Once again the department has been hit by changes in personnel and staff shortage. At the end of the year we were three inspectors below establishment strength. |
6c9a0590-0258-419c-bef8-e90d59ffea71 | It is hoped that the new year will bring with it the required personnel to enable the work to proceed on a routine basis. SANITARY CIRCUMSTANCES OF THE AREA. Statistical tables showing the work of the sanitary inspectors are set oat in the appendix. The year produced fewer complaints than in the previous year, the number being 1,474 as compared with 1,615 in 1952. There has been difficulty in coping with the many duties owing to staff shortage. This is reflected in the statistical tables. Complaints were investigated without delay and where necessary, action taken. The statistical tables set out in the appendix show the number and type of inspections made, the number of notices served, and compliances therewith. At the commencement of the year there were two properties referred for default action under the nuisance section of the Public Health Act 1936. |
831f10f0-8bed-499d-82a6-29ea064ddef4 | An additional 30 were added during the year, making a total of 32 properties which were dealt with as follows :— 30 repaired by owners 2 remaining outstanding In addition to the above work, in one instance work was carried out by the Borough Engineer in default of the owner in accordance with the provisions of Section 45 of the Public Health Act. Rainfall. During the year rain fell on 213 days with a rainfall for the year of 19.68 inches compared with 20.13 inches for the previous year. water supply. The whole of the water supplied to domestic dwellings is drawn from the main supply of the South Essex Waterworks Company. Page 59 Samples were submitted monthly for bacteriological examination and twice during the year for chemical examination, all of which were found to be pure and wholesome. In addition samples of water drawn from the wells at three factory premises using the supply for drinking purposes have also been examined, and found satisfactory. RIVERS AND STREAMS. |
b0d6519c-3d63-451d-8e1f-a42dbf53a3d4 | The major improvements at Loxford Water and the Mayesbrook are now in progress and it is hoped will be completed by the middle of 1955. These works were referred to in the last Annual Report. The following improvements have been carried out :— At the Mayesbrook the stream has been widened and fitted with sluice gates with a complete diversion of the watercourse to Mayesbrook Park Lake. A diversion of the Loxford Water to the north side of the railway has been carried out and the water will now discharge into the River Roding near the cul-de-sac at end of Victoria Road. A culvert 1,000 feet in length has been built. The pollution of the Thames and Roding is still a major nuisance. We wish all speed to the constructional activities of the London County Council at the Northern Outfall Works. SUPPLY OF DUSTBINS. |
33be4e57-ea9c-4491-9232-209081c8af05 | The number of premises where dustbins are supplied and maintained by the Corporation in accordance with Section 75(3) of the Public Health Act, 1936, at the end of the year was 5,119. Action taken under sub-section (1) of that section early in year resulted in appeals against notices in four instances nd in each case judgment was given against the Council. Further consideration is therefore being given to the question but at the end of the year no conclusion had been reached. The number of dustbins supplied by the Corporation during the year under maintenance arrangement was 404 and in addition 546 dustbins were supplied by the London County Council to their tenants after service of preliminary notices. PUBLIC CLEANSING AND REFUSE DISPOSAL. The quantity of refuse collected and disposed of during the year was 60,130 cubic yards. The average weight 6-cwts. per yard. Page 60 total weight 17,343 tons. |
03ac1069-643b-4c50-bbfc-9bd54239ab14 | There was in addition 50,630 tons of refuse received from other Boroughs at the Corporation tip. The tip at Jenkins Lane was closed in May and a new tip was opened at Renwick Road. This new tip will provide accommodation for about 20 years tipping. Permanent buildings for personnel and equipment are to be erected. Disposal was carried out at both tips in accordance with the provisions of the Essex County Council Act, 1933 (Third Schedule). CONTROL OF PESTS. (a) ERADICATION OF BED BUGS. It is with much pleasure that I am able to report a continuing decrease in the number of bug infested premises. Seventeen such premises with minor infestations required action. Fourteen of these properties, which were treated with insecticide, are owned by the Corporation. (b) FLY NUISANCE. |
f04cf905-dd81-4bad-b04f-e47f7dfde6a9 | The seasonal treatment of vacant lands, refuse tips, piggeries, stables, fishmongers and butchers premises was continued during the warm weather with satisfactory results. The Borough experienced a minor seaweed fly (Coelopa frigida) infestation it three factory premises using tri-chlor-ethylene. Remedial measures were taken by your officers and the infestation was brought to an end with the application of gammexane by the mobile spraying unit of the Corporation. The annual cost of this fly prevention service remains at £150. (c) PREVENTION OF DAMAGE BY PESTS ACT, 1949. RODENT CONTROL IN SEWERS. |
61434120-37e2-4d8a-81ba-61175b3c18e0 | The half-yearly treatments of sewers were carried out during the months of May and November, the results being as follows :— May November Number of manholes baited 400 397 Number showing bait take 170 193 Number showing complete bait take 66 81 Prior to the May treatment test baiting was carried out throughout the more recently developed areas of the Borough where only minor evidence of infestation has hitherto been found, with the following result Page 61 Number of manholes tested 73 Number showing bait take 6 SURFACE INFESTATION. The following information taken from the Annual Report furnished to the Ministry of Agriculture and Fisheries for the year 1953 shows the degree of infestation dealt with by the department. The charge for this service remains at 5s. per hour for business premises. Private dwellings are serviced free of charge. 1. PREVALENCE OF RATS AND MICE. Type of Property No. |
b7696c77-649d-46aa-938d-555264698ff5 | of properties in Area in which infestation was found Analysis of Col. 4. Number infested by (1) (2) (3) (4) RATS MICE Only Total Notified by Occupier Otherwise discovered Total Major Minor Local Authority's property 29 10 — 10 — 7 3 Dwelling houses 20,555 105 241 346 — 301 45 Business premises 1,599 29 61 90 — 71 19 Totals 22,183 144 302 446 — 379 67 2. MEASURES OF CONTROL BY CORPORATION. Type of Property No. of properties inspected No. of inspections made No. of notices served under Section 4 No. |
dc8aec32-838f-40f6-8019-5925693dd215 | of treatments carried out by arrangement with Occupier Under Section 5 Treatment Works Rats Mice only Rats Mice only Local Authority's Property 10 25 — — 12 5 — — Dwelling Houses 346 614 — — 301 45 — — Business Premises 290 530 — — 256 33 — — Totals 646 1,169 — — 569 83 — — Page 62 OTHER PESTS. There is a developing demand by residents to deal with other seasonal pests, ants, earwigs, wasps and may-fly bugs. Advice and assistance is given in the practical application of remedies Our complaints arise mainly from residents living near allotments or other stretches of open spaces. ATMOSPHERIC POLLUTION. Since the smog conditions which occurred during the 5th-9th December, 1952, attention is being increasingly directed to the pollutants of town air which it is thought caused the serious increase in the deaths during that period. |
e21f7251-1ddb-4b2b-aa0b-6115de0e8758 | This smog was the most disastrous that has occurred for 80 years, the possibility of it arising from a freak weather condition or changes in the character of air pollutants is being investigated. In connection with the possible "unusual" constituents of the atmosphere consideration is being given to the problem of sulphur emission from modern high-temperature coal-fired furnaces such as electricity generating stations. Because of this possibility and because the Barking generating station is the largest in the country the Council called the attention of the Ministry of Fuel and Power and Dr. Somerville Hastings, M.P. to what may be an insiduous risk to health from the burning of huge quantities of coal with the emission of thousands of tons of sulphur compounds. The subsequent sulphuric acid mist which is formed from such emissions by the absorption of water from the atmosphere is increased as the result of the modern improved rate of combustion with the possible harmful results. |
d216627c-def8-4966-b031-3835c4cd8fb3 | The Council is alive to these possibilities and is one of the local authorities taking part in the investigation of atmospheric pollution conducted by the Department of Scientific and Industrial Research. Measurements of the pollution in Barking are taken at three Points in the Borough and are co-ordinated monthly, with similar observations made throughout the whole of the country. It is realised today that any real step forward must have relation to domestic fires. To this end a recommendation was made to the Council that the tenants of the Thames View estate now being developed should burn none but smokeless fuel. Control it was suggested should be obtained by including a clause in the conditions of tenancy. Page 63 Page 64 ATMOSPHERIC POLLUTION—MONTHLY SOLID DEPOSITS IN TONS PER SQUARE MILE MONTH 1948 1949 1950 1951 1952 1953 D.56 D.57 D.58 D.56 D.57 D.58 D.56 D.57 D.58 D.56 D. |
cad8f8f9-213a-41e4-a611-d6046b5b41e0 | 57 D.58 D.56 D.57 D.58 D.56 D.57 D.58 JANUARY — — — 20.94 35.55 29.65 20.57 28.27 21.18 21.80 35.56 32.87 17.38 24.30 22.29 30.48 28.61 22.32 FEBRUARY — — — 19.44 28.68 28.23 24.26 43.80 36.14 30.87 45.10 36.42 12.52 17.11 11.07 30.52 23.24 24.97 MARCH — — — 15.22 24.44 21.01 18.17 26.38 24.55 17.32 22.99 32.70 25.46 29.36 26.58 20. |
eadcc97b-bca1-4154-bfd7-8f57845a42c4 | 48 22.38 14.30 APRIL 21.73 30.52 23.25 24.16 27.37 28.99 23.89 29.29 20.98 18.17 22.85 23.39 19.16 21.79 26.72 22.41 19.88 21.94 MAY 22.93 23.13 19.87 25.08 26.93 26.89 16.02 11.83 10.20 17.62 23.65 21.49 26.11 22.28 21.08 — 21.52 17.47 JUNE 16.45 28.20 22.59 17.25 21.56 19.88 23.37 18.33 14.50 23.48 30.15 23.93 29.33 19.67 17. |
28225830-94f4-486f-82f9-d972cd4f2bad | 78 25.58 26.52 12.28 JULY 12.20 15.19 11.62 27.89 26.11 22.66 21.83 26.07 25.55 17.25 19.95 23.49 17.18 — 12.10 26.94 24.64 24.79 AUGUST 25.01 29.29 22.94 23.78 32.34 24.97 29.87 21.25 26.62 16.15 23.51 24.97 30.66 35.90 16.16 25.74 22.89 21.49 SEPTEMBER 17.14 22.00 21.05 20.94 25.46 26.65 19.23 33.10 20.91 17.11 28.85 27.93 23. |
7b0fd460-45a4-4d29-b0f3-b022173f5395 | 24 19.92 19.09 30.71 27.75 21.18 OCTOBER 20.05 28.37 26.72 44.35 51.81 47.90 18.89 23.41 19.88 12.11 25.66 26.76 25.35 26.08 22.59 45.89 28.92 21.56 NOVEMBER 31.96 52.18 51.24 21.42 33.98 32.98 37.44 43.02 34.63 23.72 50.13 36.80 — 21.66 20.81 33.55 31.79 21.94 DECEMBER 20.64 43.04 32.74 19.44 29.23 24.83 25.60 29.64 30.69 23.68 22. |
7a6e30da-e681-49f8-892f-a1a0a2e606be | 57 41.99 45.46 35.86 29.57 41.59 44.04 31.74 Averages 20.90 30.21 25.78 23.30 30.29 27.84 23.26 28.70 23.82 19.94 30.08 29.48 28.19 24.90 20.49 30.25 25.18 21.33 + . STATIONS. D.56 =Barking Park —Alfreds Way from May, 1952. D.57 =Greatfields Park. D.58 =Parsloes Park. Page 65 ATMOSPHERIC POLLUTION SULPHUR DIOXIDE READINGS MEASURED AS MILLIGRAMS OF SO3 PER DAY COLLECTED BY 100 sq. C.M. |
e6e4a1ad-4c74-48cc-a5a9-0fe112b68dd2 | LEAD PEROXIDE MONTH 1948 1949 1950 1951 1952 1953 D.56 D.57 D.58 D.56 D.57 D.58 D.56 D.57 D.58 D.56 D.57 1 D.58 D.56 D.57 D.58 D.56 D.57 D.58 JANUARY — — — 3.95 4.69 4.64 2.28 2.85 3.01 2.29 2.60 1.97 2.04 2.84 2.14 3.50 4.06 3.09 FEBRUARY — — — 3.19 4.17 3.92 2.70 3.99 3.44 2.14 2.24 1.81 2.16 2.82 2.38 2.68 2.98 2. |
fd1a76dc-d5d1-48a6-a650-39e9c50f78fe | 01 MARCH — — — 2.75 2.31 2.64 2.07 2.78 2.77 1.48 2.05 2.09 1.57 1.28 1.68 2.89 2.57 2.77 APRIL — — — 1.76 2.29 2.41 1.77 2.31 2.39 1.31 1.48 1.29 0.95 0.98 1.08 2.16 2.48 2.03 MAY — — — 1.22 1.69 1.56 0.42 1.00 1.41 0.43 1.06 1.05 0.72 1.04 0.77 1.53 1.17 1.50 JUNE 1.00 1.6 1.4 0. |
fbe5c08f-1455-4d73-9863-0227c0f7853b | 94 1.50 1.27 1.00 1.72 1.58 0.55 0.85 0.55 0.04 0.65 0.58 1.27 1.35 0.97 JULY 1.98 1.53 1.25 0.66 0.96 0.73 0.62 1.68 1.43 0.72 1.11 0.97 0.50 1.19 0.78 2.19 2.23 1.82 AUGUST 1.28 1.77 1.68 0.89 1.12 0.96 1.07 1.98 1.53 0.87 1.37 1.01 0.75 1.41 0.77 2.43 2.05 1.57 SEPTEMBER 1. |
ed937b1c-0673-4679-a88a-d1ec4e8f2c96 | 68 2.49 2.37 0.67 0.90 0.83 1.56 2.36 2.58 0.94 1.53 1.21 1.02 1.10 0.65 2.18 1.75 1.75 OCTOBER 2.42 3.13 3.08 1.84 2.38 2.45 1.20 1.48 1.06 1.21 1.63 1.50 1.63 1.54 1.93 2.53 1.84 1.78 NOVEMBER 3.62 4.25 4.71 1.31 2.51 2.74 2.14 2.31 1.85 1.82 1.99 1.68 1.96 2.23 2.15 4.15 3. |
8c51fcb9-b8eb-477a-a662-5c6e8ddd1be3 | 91 3.51 DECEMBER 3.09 3.83 3.45 2.63 3.95 3.47 1.91 2.25 1.91 1.35 1.88 1.83 3.77 3.24 3.96 3.38 3.08 3.15 Averages 2.01 2.66 2.56 1.82 2.62 2.30 1.56 2.23 2.08 1.26 1.64 1.41 1.43 1.70 1.57 2.57 2.46 2.16 56= Barking Park up to December, 1952, and thereafter Alfreds Way. D.57 = Greatfields Park. D.58=Parsloes Park. |
7e35ceb2-4ad8-43d7-a28c-a6f0db8ed19f | The estate which will have 2,000 families upon completion would have provided an example of what could be achieved. The Council did not at this first attempt accept the proposal. The tables on pages 64-65 give comparable results of pollution for the years 1948-1953. As a result of the enquiries addressed to Dr. Somerville Hastings, M.P. and the Minister of Fuel and Power, information was obtained regarding the removal of sulphur gas from the flue gases of Power Stations, and the proposed future disposition of Power Stations. The Ministry of Fuel and Power has stated that flue gas washing is only possible in certain sites with an ample supply of water. It appears that in the case of the Barking Generating Station it is not possible to use the River water for this purpose because it has already been used at Battersea and Bankside and is therefore not suitable. |
d5d472fd-373f-43c0-a8de-0d5ce32eace3 | Experiments are being undertaken with another system of removing sulphur gas which may provide a saleable product and may therefore be operated at less than cost to the community. No further information has been elicited on this system. In reply to an enquiry by Dr. Somerville Hastings, M.P. the Chairman of the British Electricity Authority stated that the height of the chimneys of the Generating Stations had been carefully planned after consultations with an eminent meteorologist so that all gases are rapidly dispersed into the upper atmosphere. It may be however, that under certain atmospheric conditions dispersal would not take place, resulting in a higher concentration of sulphur gases in the neighbourhood of the Generating Station. In a later letter the Ministry of Fuel and Power stated that with the completion of more Generating Stations and the feeding of the grid system from Stations situated far from centres of dense population, the use of the older plant at Barking will be discontinued except for intermittent running at peak periods. Dr. Somerville Hastings, M.P. |
50fa961c-7079-449c-8ea9-8ca5da4cbe83 | put down questions on the subject in the House of Commons. In answer, the Minister of Fuel and Power said the problem of removing Sulphur Oxides from flue gases is the subject of continuous research. He reiterated the statements made above and added that a steady decrease in fuel consumption at the Barking Generating Station is expected because of the retirement of the older plant. This will reduce the emission of sulphur gases. He stated that the method of sending out the smoke through tall chimneys at high temperature and, by fans, at a high velocity is the best practical Page 66 method known to engineers apart from the method of gas washing, which some experts consider not to be very satisfactory. In reply to a further question the Minister agreed that in dense fogs of several days duration the gases would descend in the neighbourhood, but he said that with fogs of short duration and limited height, this would not be so. FLOOD DAMAGE. |
c6c37594-fef7-42e4-bcf0-d01b897685d5 | The disastrous flood which caused serious damage and loss of life in the Eastern Counties affected two small areas in Barking, at Creekmouth and West Bank. The water entered into 65 houses and whilst none of these were rendered uninhabitable there was considerable damage to furniture and household effects. In many of the houses the floor covering was ruined or extensively damaged. The removal of this covering revealed defects in the floors of a large number of premises, some of which were the result of normal decay. These were renewed after service of sanitary notices. In order to dry out the houses a free issue of 5-cwts. of coal was made to each householder. One of the worst features of the flood was the deposition of silt in the areas covered by water. To assist in cleansing the ground a supply of lime was issued for use in the gardens and sub-floor areas. Financial grants from the Lord Mayor of London's Fund were made to those whose household effects had been damaged, and in order to restore decoration. |
2fca2609-ec8c-4776-b2fb-c7cd1499cce0 | SWIMMING BATHS AND POOL. East Street Bath.—The season opened on 25th April and closed on 27th September, 1953, a period of 22 weeks. During this period the bath was used by 63,441 bathers, including 37,738 children. The slipper-baths were once more well patronised. During the year they were used by residents on 42,614 occasions. Swimming Pool—Barking Park.—Owing to the inclemency of the weather the season in the early part showed poor results in numbers of bathers. There was an improvement during August and September. The total number of bathers was 78,828. Of this number 54,722 were children. Page 67 Samples of baths water were taken during the year as follows East Street Bath 7 Swimming Pool 5 Bath at South East Essex Technical College 11 The Analyst reported that the samples were on each occasion of a high standard of bacterial purity. |
42c8e8cc-9863-47be-9a8e-653e040863ea | BURIAL OR CREMATION OF THE DEAD. The unclaimed body of a child which was found dead was disposed of by burial in accordance with sub-section (1) of Section 50 of the National Assistance Act, 1948. PET ANIMALS ACT, 1951. In accordance with Section 1 of this Act, Licences for the keeping of pet shops have been issued to eight persons within the Borough. Sixteen inspections of their premises were made during the year to ensure that the accommodation and general welfare of the animals is satisfactory. FACTORIES ACT, 1937. The Act places upon the local authority the duty o enforcing the provisions of Part I (Health, General Provisions) which deals with cleanliness, overcrowding, temperature, ventilation, drainage of floors and sanitary accommodation. Statistics showing the activities of the sanitary inspectors in the administration of the Act are set out in page 73. FOOD. NEW LEGISLATION. |
b2e19faf-4df6-49c2-9b19-ed178a430954 | There became operative during the year :— The Offals in Meat Products Order, 1953 The Public Health (Infectious Diseases) Regulations, 1953 The Labelling of Food Order, 1953 The Public Health (Preservatives, etc. in Food) Regulations, 1953 The Food Standards (Ice Cream) Order, 1953 Page 68 The Cream and use of Milk (Revocation) Order, 1953 The Food Standards (Preserves) Order, 1953 The Merchandise Marks Act, 1953 The Food Standards (Saccharin Tablets) Order, 1953 The Public Health (Condensed Milk) (Amendment) Regulations, 1953 The Milk (Special Designation) (Pasteurised and Sterilised Milk) Amendment Regulations, 1953 Memo 3 Meat The Milk and Dairies (Amendment) Regulations, 1953 Disposal of Condemned Meat and Offal SAMPLING. |
Subsets and Splits
No community queries yet
The top public SQL queries from the community will appear here once available.