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Ac 4411 (1) BARR 96 Library Room A104 THE HEALTH OF BARKING 1962 BARR 96 ANNUAL REPORT OF THE MEDICAL OFFICER OF HEALTH FOR BARKING FOR THE YEAR 1962 CONTENTS Pages 1. MEMBERSHIP OF COMMITTEES1-2 2. STAFF 3-5 3. PREFACE 6 4. GENERAL PUBLIC HEALTH 7-19 5. PERSONAL HEALTH SERVICES 20-30 6. SCHOOL HEALTH SERVICE 31-44 7. REPORT OF THE CHIEF PUBLIC HEALTH INSPECTOR 45-73 PUBLIC HEALTH COMMITTEE as at December 1962 Chairman - Alderman Mrs. JULIA H. ENGWELL Vice-Chairman - Councillor Mrs. J. CALLAN The Mayor - Mr. Councillor S.C. SIVELL, J.P. Alderman Mrs. AM. MARTIN Mr.
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Councillor H.E. HAMSHERE, J.P. Mr. Alderman J.R. SWEETLAND, C.C. Councillor Mrs. D.M. JONES Councillor Mrs. M. BREDO, C.A. Mr. Councillor C.A. POOL Mr. Councillor H.J. CLEAVER Councillor Mrs. M. PRESTON, C.C. Councillor Mrs. D.M. GLENNY, M.B.E., C.C. Mr. Councillor L.E. WATKINSON Mr. Councillor LEONARD WRIGHT, J.P. Councillor Mrs. C.S.M. GODFREY, J.P. BARKING COMMITTEE FOR EDUCATION as at 31st December, 1962 Chairman - Mr. Alderman G.J.G. BEANE, J.P.
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Vice-Chairman - (Vacant) Representative Members:- Mr. Alderman A.E. BALL, J.P. Councillor Mrs. C.S.M. GODFREY, J.P. Alderman Mrs. M. BALL, C.A. Mr. Councillor A. GRAY Alderman Mrs. J.H. ENGWELL Mr. Councillor I. GREENHOUSE, J.P.,C.C, Alderman Mrs. A.M. MARTIN Mr. Councillor L.F. HENSTOCK Mr. Alderman J.R. SWEETLAND, C.C. Mr. Councillor H.J. HILLS Mr. Alderman W.G. WERMERLING Councillor Mrs. D.M. JONES Councillor Mrs. M. BREDO, C.A. Councillor Mrs. M. PRESTON, C.C.
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k. Councillor J.A. BUTLER, J.P. Mr. Councillor S.R. ROWE Councillor Mrs. D.M. GLENNY, M.B.E C.C Mr. Councillor S.C. SIVELL, J.P. Mr. Councillor J. WARD Co-opted Members:The Rev. T. HALL Mr. A.E. GREEN The Rev. L. HESTON Mr. F.H. KING The Rev. Prebendary J.D. WAKELING Mr. E.R. McKEE Mrs. E. BATEMAN Mr. A. STONE Nominated Members:- Mr. County Alderman K.E.B. GLENNY, O.B.E., J.P. Mrs. E.O.
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LAW BARKING HEALTH AREA SUB-COMMITTEE of the Essex County Health Committee as at December 1962 Chairman - Alderman Mrs. JULIA H. ENGWELL Vice-Chairman - Councillor Mrs. J. CALLAN Barking Borough Council Representatives:The Mayor - Mr. Councillor S.C. SIVELL, J.P. Alderman Mrs. A.M. MARTIN Mr. Councillor H.E. HAMSHERE, J.P. Mr. Alderman J.R. SWEETLAND, C.C. Councillor Mrs. D.M. JONES Councillor Mrs. M. BREDO, C. A. Mr. Councillor C.A. POOL Mr. Councillor H.J. CLEAVER Councillor Mrs. M. PRESTON, C.C. Councillor Mrs. C.S.M. GODFREY, J.P.
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Mr. Councillor L.E. WATKINSON Mr. Councillor LEONARD WRIGHT, J.P. Essex County Council Representatives:- Alderman Mrs. M. BALL, C.A. Mr. County Alderman K.E.B. GLENNY, O.B.E., J.P. Mr. County Councillor A.C. BERRY County Councillor Mrs. S.M. BOVILL County Councillor Mrs. D.M. GLENNY, M.B.E. County Councillor Mrs. L. FALLAIZE County Councillor Mrs. M. SMITH The Executive Council for Essex Representative:Mr. F.A. WORTLEY The Essex Local Medical Committee Representative.:Dr. M. LEWIS The Hospital Management Committee Representative.:- Mrs. D.L. BELCHAMBER Voluntary Organisations' Representatives:Mrs. M.E. DALLEY Mrs.
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P. CLAYDON Mrs. G.M. GRAFFY Miss M. NOEL 2 STAFF 1962 Medical Officer of Health, Area Medical Officer and Divisional School Medical Officer MARGARET I. ADAMSON, M.B., B.Ch., D.P.H. Deputy Medical Officer of Health, School Medical Officer Assistant County Medical Officer J.J. SLOME, M.R.C.S., L.R.C.P., M.B., B.S., D.Obst., R.C.O.O., D.C.H., D.P.H., D.I.H. School Medical Officers and Assistant County Medical Offlcers:- Dr. VIOLET SPILLER, M.D., M.R.C.S., L.R.C.P., D.P.H. Dr. EILEEN E.V. MARTIN, M.B., B.Ch. Dr. E. KLEIN, L.R.C.P.& S. Dr. D. BURGESS, M.D.
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General Practitioner Medical Officers Dr. S.K. ROY Dr. P. ELSON Dr. M. LEWIS Dr. S. FRANKS Dental Offlcers:- Mr. A.R. ABEYASINGHE Mr. J.K. WHITELAW (Terminated 30.9.62) (Commenced 19.11.62) Sessional Dental Officers: Mr. L.P. HENRY Mr. H. NYMAN (Terminated 27.11.62) Miss F. PLAWES Miss B. JENNINGS Mr. A. SMITH (Commenced 10.7.62) Superintendent Health Visltor:Miss G.L. BEN FIELD Health Visitors/School Nurses etc:Miss S. BERGSTROM (Commenced 28.8.62) Mrs.
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M. KALU (Commenced 2.7.62) Miss J McGILVRAY(Terminated 30.6.62) Miss C.M. BROWNING Miss E.G. PARRY Miss A. CATTLE Mrs. R.L. ROBERTSON Miss M.T. DOWD Mrs. A.M. SMALL (Part-time) Miss L.A. GOODACRE Miss E.M. SCHROPFER (Tuberculosis Visitor) Mrs. D.G. GORDON-WILSON Miss G.K. JEFFREYS (Deceased 21.5.62) Mrs. CORRI (Part-time Tuberculosis Visitor) 3 STAFF 1962 - Continued Ante Natal Clinic Sister:- Miss R. WILLIS Dental Attendants:- Mrs. P. BURBIDGE Mrs. LA.
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ROURKE Miss P. CHANDLER (Commenced 27.8.62) In addition 16 part-time Nurses are employed for the staffing of the various Clinic services Chief Clerk:Mr. G.H. RUFF Senior Administrative Assistant:- Mr. B.S. WEAVER Administrative Assistants:- Mrs. E.M. BARTHOLOMEW (School Health Service) Miss H. BEARTON (Handicapped Pupils and Special Children) Mr. S. DEEKS (Supplies and Maintenance) Mr. A. LONGMUIR (Prevention of Illness: Care and After-Care) Non-Medical Supervisor of Midwives:Miss E. O'CONNOR District MiduMves:Mrs. LM. BRONNICK Miss A. CUNNINGHAM Matron of Day Nursery:Miss F.B. NASON Senior Dental Technician:Mr. J. CONSTABLE Domestic Help Organiser:Mrs.
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L. EVERITT Speech Therapists: Mrs. J. HOULDGREAVES Mrs. S. GIRLING (Part-time) Chief Chiropodist:Mr. H. LEAVESLEY 4 STAFF 1962 - Continued Occupational Therapist:Miss Z. MERCER REGIONAL HOSPITAL BOARD STAFF Consultant Ophthalmologist Dr. R.F. JAMIESON Consultant Obstetricians.:- Mr. B.G. SPIERS, F.R.C.S. Miss J. LAMBERT, F.R.C.S. Consultant Paediatrician:Dr. T. SAVAGE Consultant Ear, Nose and Throat Surgeon:Miss M. MASON, F.R.C.S. Consultant Dermatologist:- Dr. P.M. DEVILLE Consultant Orthopaedic Surgeon:Mr. B. WHITCHURCH-HOWELL, F.R.C.S. Superintendent Physiotherapist:Mr.
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T. HYND Orthoptist:Miss M. LEWIS 5 TOWN HALL, BARKING, ESSEX November 1963 To the Mayor, Aldermen and Councillors of the Borough of Barking Mr. Mayor, Ladies and Gentlemen, In presenting my Annual Report for 1962 I wish to thank the members of the Council for their kindness and consideration. In addition I should like to place on record my appreciation of the help and support given me by my colleagues during the year under review. I am, Mr. Mayor, Ladies and Gentlemen, Your obedient Servant, Medical Officer of Health 6 GENERAL PUBLIC HEALTH SHORTAGE OF HOSPITAL ACCOMMODATION It la now definite that the rebuilding and extension of Barking Hospital will commence in 1963 and it is hoped that this will reduce the serious shortage of beds in the II ford and Barking district. The site of the present hospital, an area of 21 acres, is Ideally situated.
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The principal new buildings will be a block of seven floors accommodating a new out-patients' department, X-ray department, physiotherapy, operating theatre and other departments to serve the wards on the four upper floors, as well as existing wards. In addition there will be a block of three floors, providing a new maternity unit of 42 beds, linked to the existing maternity department, and including a special unit for premature babies and others needing special care as regards temperature, humidity, etc. A special feature of the design of the new ward will be its 'L' shape with the administration unit (or nurses' station) placed centrally on each floor with a large amount of day space for the patients to walk around. On each floor there will be four single-bedded wards and four six-bedded wards. The above lay-out has become so popular in hospital rebuilding circles that it has become known unofficially as the "Barking Hospital Ward Plan"!
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An interesting feature of the new hospital will be the provision of the Central Sterile Supplies Department which will supply sterile surgical requisites to the entire II ford and Barking group of hospitals. Lastly, but most important, it is intended to make arrangements to make each patient very welcome; each department will have its own pleasant and comfortable waiting area with waiting reduced to a minimum and cups of tea available, if required. It will indeed be a pleasure to be a patient in the Barking Hospital, HEALTH EDUCATION In 1962 a serious attempt was made to develop the field of group teaching on health topics to various sections of the community.
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LECTURES GIVEN TOTAL ATTENDANCES In duty hours Out of duty hours In duty hours Out of duty hours Mothercraft and Relaxation 263 - 1,686 - Schools 21 - 644 - Others 22 33 392 400 Film shows given 2 1 12 130 tot111als 308 34 2,734 530 7 Two Denial Health Exhibitions were held in schools during the year. A float was entered in the Barking Town Carnival depicting the serious problem of "Smoking and Lung Cancer". Mothercraft classes In the Ante-Natal Clinics are now well established and well attended. These classes do much to help young pregnant women to adjust themselves to motherhood and in the discussion groups many "old wives' tales' with their resultant fears are dispersed. There is also a great opportunity at this time to discuss prevention of physical and mental Ill-health whilst teaching them the basic skills of handling and "bringing up babies".
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Talks on First Aid, Personal Hygiene and Mothercraft have been given to classes of girls In a secondary modern school. The girls themselves, with the addition of some boys from time to time, are a very Interested and enthusiastic audience; they are keen to attend the classes and contribute many Intelligent questions during the discussion period. It is sincerely hoped that this particular field of health education will be gradually extended to all schools in Barking. An increasing number of clubs and organisations are requesting talks on health. subjects and this is very encouraging as it is a measure by which one can gauge the growing awareness of a community to the need of Information and the possible desire to put into action the knowledge they obtain.
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During the Autumn of 1962, the older girls at Barking Junior Training Centre were given a few lecture/demonstrations on "nursing sick people in their own home The girls were so interested and showed an ability to understand and carry out simple nursing procedures that this is now a serious part of their training and if a lesson is missed there is a real sense of disappointment shown by them. The progress in this aspect of health teaching has been most stimulating and worthwhile. The limiting factor in this work will be the number of trained staff available who are competent by reason of ability and experience to give health education instruction. We are fortunate in that our efforts are greatly assisted by a member of the clerical staff who has the ability to produce original leaflets ani topical cartoons of a professional standard. NATIONAL ASSISTANCE ACT 1948 I am pleased to say that, for the second year running, there were no cases necessitating compulsory removal on account of being no longer capable of caring or themselves in their own home.
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One case was dealt with on a voluntary basis, being persuaded to enter hospital for rehabilitation whilst her home was cleansed. WELFARE SERVICE This service looks after those who no longer are able to care for them selves The following details have been supplied by the County Welfare Officer:- The table which follows indicates the extent to which the various services provided by the County Council under the provisions of the National Assistance Act 1948 have been afforded to persons having residence in the Borough of Barking during 1962. Residential accommodation for aged persons continues to be developed to 8 meet the increasing demand and a newly purpose-built home-known as Mayesbrook' and situated in Bevan Avenue - accommodating 61 persona is now fully occupied.
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Welfare Services for blind and other classes of handicapped persons are available in many ways: these include home visitation by specialised field workers, tuition in handicrafts (and Braille for the blind), recreational and holiday facilities and, especially for the handicapped person, the supply of home aids, gadgets and hoists and in addition the Welfare Committee give financial assistance towards the cost of structural alterations designed to help the handicapped person in overcoming his disability, such as ramps instead of steps, or the widening of a doorway to enable the free passage of an invalid chair. There is an occupational centre at Barking specially for physically handicapped persons, and this is proving a great asset to those able to attend, of whom 71 live in the Borough. 9 COUNTY COUNCIL OF ESSEX - WELFARE COMMITTEE RESIDENTIAL AND WELFARE SERVICES - 1962 (National Assistance Act 1948) 1.
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Number of Barking residents in accommodation provided under Section 21 (l)(a) of National Assistance Act 1948 2. Number admitted to residential accommodation during 1962. 3. Number admitted to temporary accommodation under Section (l)(a) of National Assistance Act 1948. 4. Blind Persons, etc. 5. Other classes of Handicapped Persons Registered. Registered Number employed in: Blind Partially Sighted Defective Sighted Sheltered Workshops Home Workers Scheme Open Industry Male Female Total Male Female Women Children 17 39 56 3 14 7 14 98 43 6 1 1 8 217 147 10 PUBLIC HEALTH ACT 1961 - SECTION 41 It was necessary to take action under this Section of the Act in one case during the year. It provides for compensatory payments to persons excluded from work at the request of the Medical Officer of Health in the interests of public health, and was invoked in connection with an employee at a local bakery.
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The employee concerned was proved to be a 'carrier' of Sonne dysentery and though he himself 'felt fit' it was Imperative to keep him 'off duty' till he was certified free from infection. HOME SAFETY It is perhaps not generally known that accidents in the home cause as many deaths and serious injuries as road accidents. For this reason an active home safety campaign by the Home Safety Officer and the Health Visitors has continued throughout the year. Talks, film shows and discussions have been held with adult groups, especially women's organisations who displayed a lively interest in the points which arose. Almost everyone present at these talks admitted to keeping medicines and pills which were no longer needed and consciences were pricked with regard to other dangerous practices which had become habitual, such as drying tea cloths, clothes and even wet hair over the gas stove.
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The audiences themselves were able to confirm the knowledge of the officers by commenting on, for instance, the difficulty of walking down stairs for wearers of bi-focal spectacles and the dangers to elderly or infirm people where the banister rail ends two or three steps shorter than the stairs - this fault is now being corrected in new houses. Copies of a booklet on home safety were distributed to 2,520 pupils in junior and senior schools as well as to members of adult organisations, and several of the large factories employing large numbers of women have co-operated in the campaign by displaying posters and distributing leaflets. Literature has also been given out in various out-door events in the borough throughout the year. Groups of girls in Girl Guide or Girls Life Brigade Companies are studying Home Safety as part of their efforts for the Duke of Edinburgh's Awards. A regular programme of press advertising, especially near November 5th and at Christmas, has been carried out A poster competition organised among senior schoolchildren was very ful and some very good designs were entered.
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MATTERS OF LIFE AND DEATH Population The estimated population of Barking at each mid-year for the past decade, as notified by the Registrar General, is given below. It is good to note that our population figure shows an increase this year. 1953 76,800 1954 76,580 1955 75,990 1956 75,560 1957 75,070 11 1958 74,850 1959 74,980 1960 74,920 1961 72,290 1962 72,440 Births During 1962 there were registered 1,037 live births. This is an increase of 112 over the live births in the previous year and is in accordance with the national trend of a rising birth rate. With regard to the stillbirth figure of 17, this shows a decrease from the previous year's figure of 26.
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Males Females Total Live Births Legitimate 488 493 981 Illegitimate 28 28 56 Totals S16 521 1,037 Still-Births:- Legitimate 8 8 16 Illegitimate 1 - 1 Totals 9 8 17 Total live and still-births 525 529 1,054 Birth rate per 1,000 of Estimated Population - 14.315 Birth rate adjusted by Comparability Factor of 0.95- 13.60 Still-birth rate per 1,000 (live and still) births - 16.13 I regret to say that the proportion of Illegitimate live births has increased from 4, 75% in 1961 to 5.4% this year. Maternal Mortality I am happy to report there is no record of a maternal death in 1962.
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Loss of Infant Life The infant death rate in 1962 was 4.82 as compared with 7.3 for 1961. This is the lowest infant death rate yet recorded for Barking. With this fact in mind, I delved into our archives and found our figures go back to 1896. They are so interesting I thought you would like to see them in toto:- 12 Year Barking England & Wales Year Barking England & Wales (Deaths per 1,000 live births) (Deaths per 1,000 live births) 1896 148.9 148 1930 61.3 60 1897 178 156 1931 64.4 66 1898 178 161 1932 53.4 65 1899 172 163 1933 55.6 64 1900 203 154 1934 56.7 59 1901 198 151 1935 52.
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2 57 1902 134 133 1936 56.07 59 1903 113 132 1937 53.8 58 1904 143 145 1938 39.5 53 1905 142 128 1939 33.91 50 1906 162 132 1940 32.98 56 1907 112 118 1941 36.3 60 1908 110 120 1942 35.68 49 1909 107 109 1943 37.2 49 1910 97.7 105 1944 28.35 46 1911 157.0 130 1945 38.56 46 1912 95.1 95 1946 32.79 43 1913 113.3 108 1947 31.35 41 1914 106.4 105 1948 20.
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53 34 1915 115.0 110 1949 24.8 32 1916 75.0 91 1950 27.0 30 1917 117.4 97 1951 15.49 30 1918 82.4 97 1952 21.66 28 1919 65.0 89 1953 24.77 27 1920 83.0 80 1954 20.04 25 1921 74.1 83 1955 24.49 25 1922 55.5 77 1956 19.59 24 1923 49.8 69 1957 18.55 23 1924 85.1 75 1958 18.54 23 1925 80 75 1959 28.95 22 1926 59.9 70 1960 18.07 21.
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9 1927 66.1 69 1961 17.3 21.4 1928 63.3 65 1962 4.82 20.7 1929 53.4 74 Perhaps the following pictorial representation illustrates more graphically the decline in infant mortality. 13 L_ The following tables show the causes of infant deaths:INFANTILE MORTALITY - 1962 Cause of Death Age at Death 0-1 mth. 1-3 mths. 3-6 mths. 6-9 mths. 9-12 mths. Total under 1 year Congenital Abnormality of Internal Organs 1 2 - - - 3 Pyloric Stenosis - 1 - - - 1 Found in River Roding 1 - - - - 1 Totals 2 3 - - - 5 It is interesting to note that the three Infants who died from congenital abnormalities died in hospital.
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Post Mortem examinations were done and in all cases, maIformations of the cardiac system were found. If these children had survived, a operation would have been necessary at a later date. NEO-NATAL MORTALITY - 1962 (Deaths during the first 28 days of life) Cause of Death Age at Death Under 1 wk. 1-2 wks. 2-3 wks. 3-4 wks. Total Congenital Abnormality Internal Organs 1 - - - 1 Found In River Roding 1 - - - 1 Totals 2 - - - 2 The Neo-Natal death rate was 1.92 per 1,000 live births. Other mortality rates which may be of interest are:- Perinatal Mortality Rate (Stillbirths plus deaths under 1 week) 18.03 per 1,000 live and still births. legitimate Infant death rate 4.08 per 1,000 legitimate live births.
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Illegitimate infant death rate 17.86 per 1,000 Illegitimate live births. 15 DEATHS The causes of death in 1962 are as follows:- Diseases of the Heart and Circulatory System 270 Cancer and other Malignant Diseases 185 Pneumonia, Bronchitis and other Respiratory Diseases (excluding T.B.) 87 Diseases of the Brain and Nervous System 82 Other Causes 42 Accidents, Poisonings and Violence 34 Diseases of Stomach and Digestive System 14 Infant deaths and Congenital Malformations 8 Diabetes 6 Tuberculosis and other Infectious Diseases 4 Pregnancy, Childbirth and Abortion- Total 732 Crude Death Rate per 1,000 Estimated Population 10.10 Adjusted Death Rate (Comparability Factor 1.37 = 13.84 Of the 185 deaths from malignant diseases, 65 were attributed to cancer of the lung and 52 of the 65 were men.
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As 'Cancer' is becoming a matter of topical interest, a subject no longer to be shunned but discussed by people in all walks of life, I thought it might be of Interest to analyse the figures further:- DEATHS FROM MALIGNANT DISEASES - 1962 Sex Site of Disease Age at Death Under 15 yrs. 15-24 yrs. 25-44 yrs. 45-64 yrs. 65-74 yrs. 75 Yrs.
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& Over Total M A L E Lung/ Bronchus - - 3 27 18 4 52 Stomach - - 1 7 3 1 12 Blood - 1 - - 1 4 6 Prostate - - - - - 1 1 Breast - - - 1 - - 1 Other 1 - 3 12 13 8 37 TOTAL 1 1 7 47 35 18 109 16 DEATHS FROM MALIGNANT DISEASES - 1962 (Contd.) Sex Site of Disease Age at Death Under 15 yrs. 15-24 yrs. 25-44 yrs. 45-64 yrs. 65-74 yrs. 75 Yrs. & Over Total F E M A L E Breast - - 2 11 1 3 17 Lung/Bronchus - - 1 7 3 2 13 Stomach - - - - 2 3 5
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Uterus - - 1 1 - 2 4 Blood - - 1 - - 2 3 Other - - 1 10 11 12 34 TOTAL - - 6 29 17 24 76 INFECTIOUS DISEASES The following notifications were received during the year:- Measles Tuberculosis: Respiratory 31) 37 Non-Respiratory 6) Whooping Cough 72 Scarlet Fever 26 Pneumonia 19 Puerpernal Pyrexia 8 Food Poisoning 5 Dysentery 5 Meningococcal Infection 2 Scabies 1 Erysipelas 1 Ophthalmia Neonatorum- It is pleasing to note that not one single case of poliomyelitis was notified for the third consecutive. year.
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CARE OF THE AGED As in Previous years, health visitors, home helps and visitors from voluntary associations visit as often as possible but our over sixty-fives are increasing in proportion to the rest of the population and as the span of life is now expanding to 90 and even 94, it is easy to understand that the family even though willing, are unable through through their own are (? 65-70) or infirmity to care adequately for an aged relative. We must endeavour to relieve them, if not entirely, at least partially of this burden and produce adequate facilities and accommodation for those who in the evening of their days need to be cosseted by those whom they themselves have helped so well in the past. To this end in 1962 within the Barking area, “Mayesbrook” (an Essex County) 17 Council Home) was opened. It accommodates 61 elderly persons In most congenial surroundings. Also In Its vicinity in Bevan Avenue some bungalows are being built by the Barking Corporation.
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These will accommodate 50 persons and, In addition, a resident warden will be appointed to look after the occupants. The scheme includes provision for a social hall. ESTABLISHMENTS FOR MASSAGE AND SPECIAL TREATMENT Licences were issued during the year in respect of four establishments which are governed by the Borough's bye-laws. In accordance with our requirements hot water supply is available in each surgery. LAUNDRY SERVICE The laundry service for the chronic sick and elderly has continued to help 53 senior citizens, and in the service 12,325 articles have been collected, laundered and returned. Our driver deserves special mention as in some cases his 'collection' is far from a sweet smelling parcel. PATHOLOGICAL SERVICES As in previous years, we are Indebted to the Ilford and Barking Group Hospital Pathological Service for the unfailing assistance given to us, and despite a change over of the pathologist-in-charge during 1962, the staff continued the efficient runing of the service. Dr.
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T. Ellas-Jones left the Barking Hospital staff on 31st july, 1962 to take up a more senior post in Glasgow and on the 1st November, 1962, Dr. J. Caiman commenced his duties in the vacant post. I add some interesting details of the work done In our local Barking Hospital Laboratory. Specimens for examination Bacteriology Biochemistry Haematology 1962 1961 1,783 1,683 61 44 2,132 2,217 Total specimens examined:- 1961 3,976 1962 3,944 The trend shows a decrease in examinations for infectining organisms but an increase in the realm of examinations of the blood. The ramifications of “Rhesus Typing" has resulted in blood specimens being tested in much greater detail with the resultant spotting of disease (such as Leukaemia) at a much earlier stage the was previously possible.
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As yet no routine cytological examination of "cervical smears” is carried out but I hope that in the near future it may be possible for this simple examination be done and in this way, many cases of cancer in women detected in the pre-malignant stage. 18 CHEST CLINIC Statistics relating to the notification of cases are given below:- Respiratory Meninges & C.N.S. Other Total Transfers into the area Total M. F. M. F. M. F.
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1955 37 25 1 - 2 3 68 30 98 1956 31 15 1 - 2 1 50 32 82 1957 22 6 - - 4 3 35 22 57 1958 20 14 - - 2 2 38 28 66 1959 20 17 - 1 1 2 41 38 79 1960 27 14 - 1 2 44 29 73 1961 17 15 1 1 2 2 38 22 62 1962 24 7 1 1 4 37 22 59 Dr. J.T. Paterson, the Chest Physician, and his staff have helped us considerably with the diagnosis of chest complaints, and their unfailing kindness and consideration to their patients has helped considerably when difficult decisions have had to be made.
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tag572 h1' end °' there were 624 cases of tuberculosis on the register involvouseholds, which is a slight decrease on the previous year. t«0 ""'tog attendance at the clinic sessions and the home visiting is done by Ku, m your nur8ln8 staff.
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Nearly 2,800 home visits were made during the 19 Examination of Contacts Adults Children Total New Old New Old 1955 278 417 203 683 1581 1956 215 527 185 814 1741 1957 200 690 114 922 1926 1958 101 691 95 807 1694 1959 228 705 82 798 1813 1960 79 672 99 810 1660 1961 110 680 113 809 1712 1962 88 683 89 741 1601 PERSONAL HEALTH SERVICES This section deals with those services which come under the control of the Barking Health Area Sub-Committee of the Health Committee of the Essex County Council.
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CLINIC PREMISES In connection with the future Capital Building Programme the following projects have been included:- Woodward Clinic It had been hoped that in 1962, Woodward Clinic would have been rebuilt but this project has been postponed until 1963. However the plans are well in hand and the completed new clinic - a partial two-storey building • will allow for the development and extension of our services. Special features of the proposed new clinic are a double dental suite and the provision of a sound proof room to help in the detection of hearing defects in very young children. Gale Street Nursery Our plans for the replacement of this nursery, a prefabricated building (now nearing the end of its useful life), have been altered somewhat as the original new site was to have been in the Mayesbrook area. It is now settled that when it is built the site will be in Blake Avenue, which should prove a fairly central and convenient place for the parents to take their children.
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It is nice to know it is so near to Eastbury House which several years ago was one of our day nurseries. Central Clinic This extension project is scheduled to take place in 1965-66. This clinic, though fairly extensive in area, has a large hall which is difficult to sub-divide usefully, while the smaller rooms leading off from the hall are inadequate in number and size for the varied number of sessions operating at the same time. At times, even the staff room is called into use for special I.Q. examinations. Upney Clinic The rebuilding of the Upney Clinic situated within the Barking Hospital ground is still in the distant future. The site is one in the corner of the grounds near the Upney Station and although there is a steep embankment it might be possible to build a three-storey building with the main services on the second and third floors, when the second floor would be on the level of the road.
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CARE OF MOTHERS AND YOUNG CHILDREN MATERNITY SERVICE Ante-Natal Care. This was given as follows:- 20 Clinics 645 Hospitals (excluding Barking Hospital) 91 General Practitioners 302 Total 1038 Confinements. During the year 1040 mothers were confined, giving birth to 1054 Infants (including 14 sets of twins). These were born as follows:- Barking Hospital 646 Other Hospitals 92 At home 316 At Private Nursing Homes Total 1054 In two instances patients failed to seek ante-natal care; in one case the expected baby was illegitimate and in the other, the mother ignored her condition. 'post-Natal Cart. 530 Barking mothers attended the Post-Natal Clinic making a total of 593 attendances. In addition, 302 mothers were under the care of their tally doctors and 91 were under the care of hospitals outside the district.
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nfant welfare Attendances at Infant Welfare Clinics - 1961 and 1962 1961 1962 Number of children born in year who attended 817 938 total number of children who attended 2,454 2, 806 Total attendances 22,579 22,161 distribution of Welfare Foods the following table shows the welfare foods distributed during 1961 and 1962:- 1961 1962 National Dried Milk 21,290 18,946 tins Cod Liver Oil 2,519 1,360 bottles Vitamin Tablets (A & D) 2,783 1,652 packets Orange Juice 23,271 13,098 bottles In addition, during 1962, 24,703 packets of proprietary brands of milk foods etc, were sold at clinics. GALE STREET DAY NURSERY Gale Street day Nursery is a training school for students taking the National Nursery examination Board certificate. They attend the South-East Essex Technical College for academic training and higher education.
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During 1962 we had six girls in training, one of whom sat the examination and passed, In addition, two senior students entered the Royal Society of Health Nursery Nurses Prize Essay Competition. The subject of the essay was “The Role of 21 Play Material In the Mental and Physical Development of Children under Five", and although we did not gain a prize, the competition was stimulating and the essays reflected the amount of knowledge the students had gained during their training.
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The table below shows the attendances at Gale Street Day Nursery during 1962:- Number on Average daily Register attendances January 53 32.4 February 51 39.0 March 53 42.2 April 53 45.9 May 54 46.4 June 50 41.3 July 52 37.0 August 53 38.5 September 48 37.8 October 50 42.3 November 53 39.5 December 50 35.7 Nursery and Child Minders' Regulation Act There are no registered child minders in the Borough. MIDWIFERY During 1962, six Midwives were employed in the Barking area. Twenty-one pupils did their district training and a total of 300 women were confined, which represents 30% of the births occurring in the Borough. Pupils who took Part II training on our district came from « variety of training schools including:- Queen Mary's Hospital for the East End, Stratford E. 15.
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Plaistow Maternity Hospital, Howards Road, E. 13. Ilford Maternity Hospital, Eastern Avenue, Ilford. St. Andrew's Hospital, Devons Road, Bow E.3. St. John's Hospital, Chelmsford. Oldchurch Hospital, Romford, Essex. St. Mary's Hospital, Leeds. Barking Hospital is a Part II Training Hospital for midwifery. Your Medical Officer of Health is approved by the Central Midwives Board to give the requisite public health lectures and a series of these have been conducted at the Barking Hospital. Arrangements are made on request for a midwife to attend ante-natal sessions at General Practitioner Obstetrician's surgeries, thus enabling doctor and midwife to work as a team in the patients interest. I am only too happy to encourage this co-operation and am glad to see an increasing number of requests for the services of a midwife for this purpose.
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I should like to take this opportunity of expressing my gratitude to all our midwives for the assiduous discharge of their duties which, in no small way, contributed to the low number of infant deaths recorded in 1962. 22 Supervision of Midlives Miss E. O'Connor, Superintendent of the Lady Rayleigh Training Home, has continued to undertake the non-medical supervision of midwives.
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HEALTH VISITING 1958 1959 1960 1961 1962 Home visits to expectant mothers 1266 1266 1058 1147 845 Home visits to children under 5 years 9257 8533 8750 8988 8157 Home visits to aged and handicapped 5712 6692 6079 6434 4585 No access visits 2270 2223 2506 1950 1693 Households visited 4763 4311 4242 4459 3427 These statistics show a decrease in the number of home visits made by health visltors In 1962 and the various reasons for this decrease began to happen early in the year when health visitors and clinic nurses were increasingly employed in the smallpox vaccination sessions which were then required, to cope with the panic caused at that time by the outbreak of smallpox up and down the country.
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An additional strain was caused by the amount of illness among the staff which occurred at the same time end included one or two long periods of sick leave. The death of Miss Jeffreys in May 1962 was a great loss to the families she served and to her colleagues. Miss McGilvray, another health visitor who had worked in Barking for 25 years, left Barking in June 1962 to take up an appointment of Health Visitor Group Adviser in North Devon. These two vacancies were later filled and the establishment of staff returned to the 1961 level of nine whole-time health visitors, one part-time health visitor, one full-time and one part-time TB visitors and sixteen part-time clinic nurses, against the required establishment of twenty-two health visitors. The shortage of health visitors causes concern throughout the country and in Barking we have great need of more staff to work in the growing fields of medicosocial work entrusted to them.
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We are fortunate in having a grand troupe of parttime clinic nurses who relieve health visitors considerably of clinic duties, thus enabling them to do more home visiting. The trend of younger marriages means there is a greater need for advice and guidance on the care of babies and small children. The increasing problem of old people living alone or found ill or infirm in their own houses and without adequate is another field of work which involves more and more of the health visitor's time. In the field of mental health, again health visitors are finding that they are frequently called upon to support, comfort and advise the relatives of the mentally for in many instances it is the health visitor who is first aware of the breakdown of family unity due to the mental Illness of one of its members and the distress and anxiety it causes, which in turn often creates further problems within the family.
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Many more mothers of young children are seeking employment to supplement family incomes and to help provide the now accepted emblems of modern living, i. e. television sets, washing machines, motor cars and so on, and it is increasingly difficult to find mothers at home and it is felt by many of the health visiting staff that the changing pattern of family life makes home visiting more time-consuming than in the past. Despite the changes in the field of health visiting, there is a challenge and great stimulation in the present-day problems and in devising the ways and 23 means of putting into practice the new ideas of medico-social work. In 1962 we again received two student health visitors from the Training Centre at the South-East Essex Technical College and eighteen student nurses from Rush Green Hospital for practical training. Student district nurses/midwives also made observation visits to the Child Welfare Clinics.
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The Superintendent Health Visitor has continued to give lectures on The Social Aspects of Disease" to student nurses at Rush Green Hospital and to the student district nurses/midwives from the Lady Rayleigh Training Home. A series of three talks on "Health Education" was also given by her to the student health visitors at South-East Essex Technical College at the request of the Principal Health Visitor Tutor. Three health visitors have attended refresher courses during the year on such varied aspects of preventive medicine as Health Education, The Detection of Deafness in Small Children and Mental Health. These courses are devised to enable staff to keep abreast of new ideas and techniques and are greatly appreciated. HOME NURSING This service, together with approximately half of the domiciliary midwifery service, is still administered from the County Training Home at Leytonstone.
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VACCINATION AND IMMUNISATION Smallpox In January 1962, due to the arrival in December 1961 by air of a Pakistani who was incubating smallpox, we anticipated that there might be some “consequences” this country. As things turned out, the number of cases throughout the country was comparatively small, and in this area we were fortunate to have no actual cases at all. Owing to widespread news broadcasting, etc., and the fact that in this area we have quite a large number of Pakistanis employed in various industrial firms, the Public Health Department was flooded with enquiries re smallpox vaccination. Though surrounding areas had different ideas on the subject, it was decided that it was fair to give vaccination to everyone who asked for protection against this dread disease, and during the months of January, February and March, the numbers attending our clinics for vaccination reached the hundreds. Extra clinics were instituted to meet the demand, and all the staff combined to make tlv running of the clinics as smooth and efficient as possible.
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During the week ending 20th January 1962, nineteen sessions were held including four evening sessions. The last special vaccination session was held on 18th May, 1962. Following this, the programme of vaccination reverted to normal and smallpox vaccinations were done during the ordinary immunisation sessions. In addition, medical officers visited the following factories where 5,551 employees received vaccination. Adelphi Press Limited Adhesive & Allied Products Ltd. R.J. Albon & Sons Limited Alexandra Stone Co. (Barking) Ltd. Barking Power Station F.H. Bennett & Sons Victor Blagden (Barking) Limited British Paints Limited British Printing Ink Limited C. & M. Engineering Co. Ltd. Cape Asbestos Products Ltd. Collaro Limited Delaney Gallay Limited Denton Edwards Paints Limited Dixon's Paints Limited Eastern Joinery Works Limited British East-Light Limited Express Sheet Metal Co. Ltd. 24 Flsons Fertilizers Limited Forrest Printing Ink Co.
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Ltd. Fred Fowler Limited Gilbey Engineering Co. Ltd. Highway Cooperage Limited Impalco Foils Limited Jeyea Sanitary Compounds Co. Ltd. Johnaon & Johnson Limited Kitsons Insulation Limited I, Leftley Limited S.G Lomax Limited Mack Trucks (Britain) Limited Medcraft Brothers Limited Nellaons Ice Cream Co. Ltd. Petrofina (Gt. Britain) Ltd. Potter & Clark Limited Radio Maintenance Co. (London) Ltd. Reynolds Packing Co. Ltd. Roneo Limited J.H. Sankey & Son Limited Self-Opening Tin Box Company Splendlda Limited William T. Storer & Company Suntester Limited Torridon Steel Limited Transcon Limited United Glass (Thermoplastics) Ltd. Varley Dry Accumulators Limited Weymouth Sack Co. Limited Whitmoyer-Reed Limited William Warne & Co. Ltd.
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In addition, many people consulted their own doctors and were vaccinated by them. During the "rush", a daily personal collection of vaccine was made from Colindale Public Health Laboratory, and by this arrangement we were perhaps fortunate in getting adequate supplies for the demand. Our technique of vaccination was good and very few cases of "vaccine fever" came to our notice. I should like to take this opportunity of thanking my staff and all the various voluntary helpers for their assistance In making this major operation so successful It is lamentable that a "scare" is needed to stimulate the general public to take advantage of the excellent facilities afforded by the medical services in this country to get protection against the various infectious diseases, the ravages of which have been so minimised in recent years by our immunological procedures. I shall only be satisfied when every child on reaching the age of 12-14 months has been protected against this killer disease by such a simple procedure of scar ■ fication of the skin.
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25 The following are the smallpox vaccination figures for 1962:- Quarter Primary Re-Vaccinations March G.P.'s 5,243 14,434 G.P.'s 5,408 9,114 Clinics 9,191 Clinics 3,706 June G.p.'s 463 716 G.P.'s 482 1,145 Clinics 253 Clinics 663 September G.P.'s 66 128 G.P.'s 98 130 Clin cs 62 Clinics 32 Decmber G.P,'S 15 29 G. P.'s 19 31 Clinics 14 Clinics 12 Total 15,307 Total 10,420 Poliomyelitis Vaccination In 1962 we were permitted to use oral vaccine. This is given to the children on lumps of sugar or In syrup, and is a welcome change from the usual injection.
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The total vaccinations carried out by family doctors and at clinics year were as follows:- Age Groups Children born in 1962 84 Children born in 1961 519 Children and young persons born in years 1943-1960 221 Young persons born in years 1933-1942 110 others 195 1,129 Boosters (all ages) 3,314 Diphtheria, Whooping Cough and Tetanus Immunisation During 1962 the immunisation scheme was extended to include protection against Tetanus.
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The number of children receiving primary courses of immunisation during the year was as follows:- DIPHTHERIA Family Doctors Clinics Total Separate 18 242 260 Combined with whooping cough and tetanus 222 62 284 Total Diphtheria 240 304 544 WHOOPING COUGH Family Doctors Clinics Total Separate 38 216 254 Combined with diphtheria and tetanus 220 6 226 Total Whooping Cough 258 222 480 26 TETANUS Family Doctors Clinics Total Separate 24 5 29 Combined with diphtheria and whooping cough 153 62 215 Total Tetanus 177 67 244 PREVENTION OF ILLNESS, CARE AND AFTER-CARE Chiropody Service This remains a popular service and during the year 13,427 attendances were made.
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Chiropodists practise at Central, Woodward, Porters Avenue, Greatfields and Thames View Clinics, and our establishment now includes a Domiciliary Chiropodist who gave 1,740 treatments at patients' homes and who includes “Mayesbrook” (old People's home) amongst her domiciliary visiting. When chiropody treatment of schoolchildren is undertaken (243 treatments during 1962) the opportunity is taken to discuss and advise on footwear, including stockings. If the child is unaccompanied, an interview with the parent is sought for a chat about feet and footwear, and a leaflet on foot health is issued. The response these informal chats is very encouraging, but I regret that children even as young as ten or eleven influence the decision as to the style of shoes to be purchased, even against the better judgment of the parents. I only wish that "fashion” directed a sensible shoe be worn.
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Generally, there is a great need for footwear education - not only for children, but for Parents too, for during junior years the feet can be hopelessly ruined. It is essential to discuss this with parents for with their understanding, many real improvements cun be achieved. Domiciliary Occupational Therapy-Tuberculous Patients Miss Mercer, our Occupational Therapist does a wonderful job. She is enthualastic and stimulating, and by her contagious enthusiasm in her approach to the patients she makes life for them much more worthwhile. I should like to see the scope of her activities broadened to include other type of patients. There were six Patients on the register at the end of the year. 131 Visits were made to these patients who were taught weaving, basketry, art, embroidery and rug Two patients who submitted entries for the Dagenham Town Show won prizes and basketry. 27 These patients appreciate the Domiciliary Occupational Therapy service and all work steadily to reach a high standard.
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Some patients are limited in the type of work they undertake owing to their physical condition. Work is sold at the Dagenham Town Show and also from the Showcase at 15/17 Thompson Road, Dagenham throughout the year. These sales enable the patients to pay for the materials provided by the Occupational Therapist. Sickroom Equipment Loan Scheme Our Sickroom Equipment Loan Scheme continues to develop and expand to meet the ever increasing demand as the scheme becomes more widely known. 1,256 Articles were loaned during the year and 1,193 were on loan at the end of the year. It is evident that many old people are greatly encouraged by the availability of articles such as wheelchairs and walking aids of various types, to keep as active as possible and not become bedridden.
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The expressions of thankB which are received from time to time, particularly from relatives after a bereavement, indicate that the service is greatly appreciated and not least by our district nurses who find the ready access to suitable equlpment a most acceptable aid for the nursing and comfort of their patients. With the co-operation of the County Medical Officer, hydraulic hoists have now been supplied through the County Welfare Department to a number of severely handlcapped people. These appliances are much appreciated and do much to lighten the burden of those who care for these unfortunate people in their homes. The maintenance of a sufficient and suitable panel of domestic helps to meet demands presents some difficulty because the service has to compete with the attractive conditions offered by a wide range of industries etc., in the area which employ large numbers of women. The number of domestic helps employed is now 124, of whom 98 are on the Regular Panel.
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28 DOMESTIC HELP SERVICE The following table shows the number of hours of service given during the pas ten years, together with a detailed analysis of how the hours of service were deployed in 1962. Year Number of Helps employed Number of Cases helped Total ours worked 1953 89 384 105.121 1954 89 503 101,960 1955 90 556 105,104 1956 93 596 104,863 1957 93 581 97,536 1958 97 550 103,787 1959 96 625 114,227 1960 110 672 122,026 1961 120 792 123,092 1962 124 816 124,414 The following table shows the help given to various categories during 1962:- Cases Helped 1962 Hours of Service 1962 Aged Chronic Sick (over 65 years) 501 75,
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896 |Chronic Sick (under 65 years) 126 24,599 Aged (over 65 years) 111 16,877 Maternity 40 1,661 Tuberculosis 15 3,767 Acute Sick 16 962 Other Cases 7 652 816 124,414 VOLUNTARY ASSOCIATIONS There are many voluntary associations in the Barking district which do a lot of good and useful work among the young people and by visiting housebound and lonely folk in their own homes.
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As a Health Department we are particularly interested in the Barking Association for the Welfare of the Physically Handicapped and the Barking Association for Mental Health During 1952 a house, appropriately called "Barking House", was bought at 89 Wellesley Road, Clacton, by the Physically Handicapped Association, made read for occupation in May1962 and officially opened by the Mayor of Barking on 21st July, 1962. house is a three-storey one and is intended as a self-help holiday house for families which include a physically handicapped individual. Two for even three families could occupy the house at one time. Here they can look after themselves, enjoy the bracing fresh air of this East Coast resort and do Just as they please without the restrictions of a hotel. The realisation of this “dream” possible by the many gifts, both of money and in kind, given by many well-wishers in Barking and district.
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Individuals and firms alike combined to help to buy, alter, decorate and furnish "Barking House and theirs is the thanks of the many people who otherwise would have had to forego The top storey of this house forms an attic flat used by the Working Party who spend many hours cleaning and in other ways keeping the house in order. 29 After three months or so, Casual Domestic Helps, subject to satisfactory serice, are transferred to the Regular Panel which carries with it entitlement to sick pay and paid holidays. During 1962, the Home Safety Officer gave a talk to domestic helps on the 'Hazards In the Home" which was enjoyed by all those present, and it is interesting note how this loyal band of women appreciate discussion on any subject dealing with the home. They have a flair for home making, are excellent on "making do" on limited means and thus are invaluable in their help to the housebound and the chronic sick.
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The Association for Mental Health initiated the formation of two clubs, one the "Mensana" Club held for adults every Wednesday evening at Eastbury House and intended for those who may have been mentally disturbed and where members may find companionship amongst those who understand their fallings and in helping others help themselves back to the normal routine of life. The members so far are rather few in number and there is a great need for the assistance of psychologically trained workers. The second club is the "Happy-Go-Lucky” Club, first formed in September 1961 for the children (mentally handicapped) and held every Wednesday night in Ripple School. During 1962 it continued to flourish, providing a wonderful and satisfying club for the mentally handicapped children and providing for their parents a much needed respite from their care with, on occasions, the chance of an evening theatre entertainment in Town. This club also had dreams of a bungalow by the sea and by means of houaeto-house collections, raffles, etc., some hundreds of pounds were raised.
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By a magnanimous gesture of the Variety Club of Great Britain, a gift of £2,000 waa given and the total sum was sufficient to buy a plot of ground at Holland-on-Sea and a bungalow built. The Invalid Children's Aid Association also contributed a substantial amount in the way of furniture and furnishings and on 5th December, 1962, the opening ceremony was performed by the Mayor of Barking. 30 SCHOOL HEALTH SERVICE 1962 REPORT ON THE HEALTH OF THE SCHOOL CHILDREN OF BARKING The information in this Section is given in my capacity as Divisional School Medical Officer of the Essex County Council. I wish to express my thanks here to Members of the Council and to all my colleagues in the Education and School Health Services for their help and co-operation during the ysar. 31 MEDICAL INSPECTION AND TREATMENT The statistical return at the end of this report shows the classification of defects found and the treatment thereof.
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Minor Ailment Clinics The attendances during the year at these clinics are as follows:- CASES TREATED AT MINOR AILMENT CENTRES EYES: (External and other - excluding errors of refraction and squint) 264 EARS, NOSE AND THROAT DEFECTS: (other than operative) 313 SKIN: Ringworm (scalp) 1 (body) 2 Scabies 4 Impetigo 39 Other 1,803 Other minor ailments (e.g. minor injuries, bruises, sores, chilblains, etc.) 863 Total attendances 15,563 Speech Therapy During the year, schoolchildren made 2.038 attendances to the two speech clinics (held at Central and Woodward Clinics). With new sound-recording Instruments to assist in voice production, great progress is being made in the treatment of speech defects. Only too often the defect is functional, not organic, and in these cases is related to a psychological or emotional problem in the child's environment.
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Nowadays many children are being referred for treatment at a pre-school age so that the speech therapist can help them as much as possible before starting school. This has proved to be of great value as less school time is missed and the child is less embarrassed by any speech difficulty when he does star school. Our Speech Therapists visit Faircross School (four weekly sessions) and the Junior Training Centre, Castle Green (one weekly session) regularly, and are encouraged to visit other schools as necessity arises to discuss lndividual children with the teacher. We have the services of one full-time and one part-time speech therapist, but I feel that the work needing to be done would be better covered by having two fulltime speech therapists. DENTAL SERVICES Statistics relating to the dental inspection and treatment of schoolchildren will be found in the statistical return at the end of this report.
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I am pleased to be able to report a definite improvement in the recruitment of dentists towards the end of the year, enabling us to resume dental inspections in 32 32 schools and offer treatment without delay. Furthermore, In co-operation with the Health Education team of the County Health Department, two Dental Exhibitions were arranged during the year in schools at opposite ends of the Borough. Resulting from these, our dental attendances improved, but I am afraid the importance of dental conservative treatment is still not appreciated sufficiently by parents. An increasing amount of orthodontic work is being carried out and this “Beauty hutment” though somewhat protracted in order to get the best result, is amply justified by the appreciation of both the children and parents alike. Our Dental Workshop is equipped with the most modern equipment, and the four Senior Technicians take a great pride in their work.
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We no longer have an Oral Hygienist on our staff but I hope that in the future, when there is a double dental surgery available, we may be fortunate enough to attract a “Dental Auxiliary" to our staff. The school for the training of dental auxiliaries commenced in September 1960 but as the numbers of girls trained for this Job are small, few districts have been lucky enough to get them. Their training lasts two years and on graduating they are put on the Register of Dental Auxiliaries which is kept by the General Dental Council. They are now capable of scaling and cleaning teeth, of doing uncomplicated fillings of temporary and permanent teeth, extracting temporary teeth, undertaking dental health education In schools, and so allow the School Dental Service to expand. They work to the prescription of and under the supervision of a registered dentist who must see the case on completion of the work. School Nursing Health Visitors continue their duties as school nurses in the 36 schools with a total populations of 11,745 schoolchildren.
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The work entails close contact with the children, their teachers and the parents, for many homes are visited at the request of the school medical officers and head teachers to help parents on matters of their children's health. Health Visitors assist the doctors at school medical inspections and in the vaccination and immunisation programmes in schools. They carry out the vision testing of schoolchildren and conduct regular hygiene inspections in the schools. VACCINATION AGAINST TUBERCULOSIS Our B.C.G. vaccination scheme continued during 1962 and the gratifying total of 869 tests undertaken by your doctors illustrates the co-operation of parents in what is one of the major preventive measures against tuberculosis. The Chest Physician and his staff at the Barking Hospital have assisted us in all doubtful cases and their co-operation has been invaluable.
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the statistics regarding this service are as follows:- Number to whom offered 1,073 Number tuberculin tested after parents' consent had been received 869 Positive result 91 Negative result 778 33 Students of the South-East Essex Technical College were again invited to participate although only 6 accepted. Of this number 4 had positive reactions and the remaining 2 received B.C.G. The low number of acceptances may well be due to the fact that many students have already had B.C.G. During 1961 and extending into 1962 some research was done by Dr. Eileen Martin at the instigation of and in co-operation with Dr. T.M. Pollock of the Wellcome Foundation. This was carried out at one of the Barking Secondary Modern Schools during the routine B.C.G. vaccination of schoolchildren, and its aim was to determine the relative sensitivity to avian, bovine and human tuberculin after vaccination of schoolchildren with B.C.G. The results were regarded by Dr.
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Pollock as of considerable value and his own research will be continued, using a group of nurses and students. SPECIALIST SERVICES Eye Clinics Dr. R.F. Jamieson, M.B., Ch.B., D.O.M.S., continues to attend Central, Porters Avenue and Woodward Clinics. Appointments are made as far as possible to suit patients and parents. Cases dealt with were as follows:- External and other diseases (excluding errors of 50 refraction and squint) Errors of refraction (including squint) 1,196 Total 1.246 The number of pupils for whom spectacles were prescribe was 763. Miss Lewis, Orthoptist (whose sanctum is at present in Upney Clinic), treated 140 schoolchildren during 1962. Infant Vision Testing Our work, which I mentioned in my last report relating to the Sjðgren Hand test has now reached a satisfactory conclusion.
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An article appeared in the "Medical Officer" of 26th October, 1962, summarislng the work carried out and the conclusions which we reached. Over 500 children had vision tests carried out using two different methods of testing. one of these was the Snellen Test Card which has long been accepted as reliable in adults and most older children, and the other was the Sjðgren Hand Test Which can be so useful in young and backward children. By comparing the results, it was possible to amend the sizes of the hands In the Sjogren Hand Test to correspond with the visued results using Snellen Test Cards. As a direct consequence of our work, a new set of Hand Cards has been brought out by Messrs. Hamblin, and approved by Dr. S. Sjogren, and these are avilable to hospitals, clinics, general practitioners and opticians.
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34 Two Yearly Eye Tests in Schools As a result of the findings (luring our work on "Sibling Visions* which I mentioned in previous reports and which were published in the •Medical Officer" of lst September, 1961, we continued until recently to check the vision of all school age sibling of children known to have defective vision, as well as doing the visions with our routine school medical examinations. I have, however, now reached the conclusion that too many children suffer from unrecognized and quite severely defective vision for a number of years becauss school inspections have become so widely spaced. Some of you may remember that in Dr. Williams's time we aimed at annual school medical inspections, and even with inevitable delays most children were seen at least every two years. After 1948 however, a uniform method of carrying out school inspections was gradually adopted throughout Essex, and as a result school inspections are now only carried out at school entrance, at age 11 years and at school leaving.
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Thus, some children are left up to five or more years without medical examination. Because of this long gap, I have now decided that the vision of all schoolchildren must be checked at least once every two years, and this is now being carried out in all the schools. I am afraid a large amount of extra work has fallen on the school nurses and the clerical staff and, to some extent, on the schools, but l am convinced these examinations are very important and worth the extra effort. Pediatric Clinic A Consultant Paediatrician, Dr. T. Savage of the Regional Hospital Board holds a session each fortnight at the Upney Clinic, and during 1962 schoolchildren were seen as follows:- New Cases 28 Re-examination 74 Total attendances 102 Enuresis Clinic As bed-wetttng continues to be both an embarrassing and serious problem of some school children, the subject was discussed with Dr. Savage, the Consultant Paediatrician barking Hospital.
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With his approval, it was decided to give these children more facilities for treatment A special clinic for the treatment of children with enuresis, using the Electric Buzzer Method, was started in March 1962 at Upney Clinic and is held every two weeks. Previously, such children had been seen by the Consultant Paediatrician during his paediatric clinic, but the amount of work involved necessitated a sepa- The clinic is run by the Deputy Medical Officer of Health who acts as a clinical Assistant to the Paediatrician. The administration, supply and maintenance of buzzers is done by a clinic nurse and a member of the administrative staff whole assistance is invaluable to the satisfactory running of the clinic. During a full year (March 1962-March 1963), 123 children attended the clinic, which included 53 new patients. 35 Cause of Enuresis Twenty-two children had a definite emotional or unhappy child/parent relationship, which was most certainly an important cause.
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In thirty-one children, no obvious emotional cause was found (at the first interview), but this by no means excludes its presence. In no child was any physical cause of enuresis found, but many children were heavy sleepers and this was a cause of buzzer “failure" in some cases. Treatment The only treatment given at the clinic is the electric buzzer and, of course, advice for any social problem found. Results Cured (i.e. no enuresis for two months with buzzer and patient told to return if reoccurrence) 24 (60% of treated cases) Improvement (i.e. less number of wet nights) 7 No change (advised to return in one year) 8 Unknown (moved out of area, etc.)
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9 Buzzer not issued-below age (5 years) 2 not collected 3 53 Although one cannot exactly estimate the efficiency of the buzzer method of treatment of these figures, there can be no doubt that a significant number of children are helped to overcome their unpleasant symptom, and this alone makes the time and expense involved very worthwhile. Ear, Nose and Throat Clinics Miss M. Mason, F.R.C.S., continues as the Consultant Ear, Hose and Throat Specialist. Figures for treatment are:- Operative treatment (cases):- (a) For diseases of the ear 1 (b) For adenoids and chronic tonsillitis 97 (c) For other nose and throat conditions 18 Other forms of treatment (cases) 184 Skin Clinic Dr. P.M. Deville, the Consultant Dermatologist, visits Barking Hospital once a fortnight, examines and diagnoses cases referred to him by general practitioners, medical officers and any baby cases in the maternity unit.
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Fewer infective skin conditions are seen, but there appears to be a greater preponderance of irritative skin reactions to the various chemicals used in cleaning the home. 36 As a subsidiary of the Skin Clinic, a Wart Clinic is conducted weekly by one of your medical officers. I regret to say that the incidence of warts did not diminish during 1962. Child Guidance By special appointment at our clinics, members of the medical staff now see children whose problem is not physical but emotional and evidenced by behaviour problems at home and/or school. The children are usually showing signs of emotional distress exhibited by insomnia, nervous fears, difficult behaviour, stealing (usually of a pointless variety), or a refusal to attend school. This last is known as school phobia and does not consist simply of truanting in order to have a few days' holiday, but is a fear amounting to terror of leaving home to attend school. On investigation it is rarely the school environment that is the real cause, but some situation real or imagined in the home.
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There are many such situations that tax a child's emotional strength considerably. For example, the physical or mental illness of a parent, disharmony or the threatened or actual break-up of a marriage or less dramatic occurrences such as the removal to a new area or the arrival of a new baby. In some cases full discussion of the matter with the parent and the enlistment of the understanding assistance of the teachers enables the child to be helped over the difficult patch, and thereafter a watching brief may be all that is necessary on the part of the school doctor. In other cases, however, the child is referred to the Child Guidance Clinic either immediately or after an observation period. In cases of school phobia in particular, early and urgent referral to Child Guidance has been found to be the best course of action. It should be mentioned that a physical check is made of all cases to exclude organic cause. The actual nmber referred to the Child Guidance Clinic was 32.
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These 32 cases require m ly hours of patient home visiting and treatment by the staff of the Ilfordrd Child Guidance Clinic who always give us the greatest help in dealing with the Psychological problems of childhood. I am convinced that the medical profession in this district come across many other children who would benefit from attendance but refrain from referring any but the most severe cases on account of the delay in receiving treatment. This is not a fault of the present child guidance Clinic, but is a question of more staff or an extension of the Guidance service. The Magistrates Court- opened in the old Town Hall in August 1960 - also refer cases to the Child Guidance Clinic and some of these are Barking children. perhaps if they had been referred at an earlier date there might not have been the necessity to go via the Court.
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I wish to thank Miss C. Helen Watt, Educational Psychologist, Ilford Child Guidance Clinic, for the following report on "The School psychological Service “I am glad to say that I have now had contact with almost all the schools in Barking and I have Particularly welcomed the opportunities I have had to discuss individual children in some detail with their head teachers and with their own class teachers, who know the children's reactions in class from day to day and can add detailed observations to the information given by the head teacher. This 37 is an enormous help in assessing the need for recommending measures such as special schooling or referral to the Child Guidance Clinic. I am grateful to the Barking head teachers for so willingly giving me the opportunities to meet individual teachers. It is very good news that the facilities for remedial teaching in the area are likely to be increased in the near future as it is proposed to set up a remedial class at Monteagle Junior School.
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The setting up of this class in addition to the existing remedial class at Roding School which does such excellent work, will mean that remedial teaching facilities will be available for children of Junior School age over a larger area of the borough. There will still be a small area at the west end of the borough in need of more local facilities of this kind so I hope there will be further growth in the remedial teaching service in the borough. During the year I had two or three meetings with the Borough Education Officer, Mr. Haselden, who was most encouraging in his attitude and kindly invited me to attend a head teachers' meeting so that I had the valuable experience of meeting the head teachers in a group and giving a short talk to them.
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In the talk I gave my views on the need for specialised remedial teaching for children who are working below their ability and suggested some alternative ways in which a local authority can meet this need; full-time remedial classes in ordinary schools, a group of remedial classes in self-contained premises and peripatetic teachers taking groups of children part-time. In the ensuing discussion it was clear that the type of help desired differed from school to school according to the type of learning problems usually encountered in a particular area. Soon after the talk a collection of books suitable for remedial teaching was made available to any of the head teachers and class teachers the borough who wished to see it. They were invited to attend the Ilford Child Guidance Clinic to see the display of books and some interesting discussions and comments on the books arose out of this, from those who attended. I am still concerned at the predicament of a few Secondary schoolchildren who are in great need of remedial teaching.
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During the past two years I have been carrying out a survey of reading back wardness in the Barking Secondary Schools in order to get an idea of the size of the problem and to assess how many of the children with severe reading difficulties could be expected to respond to intensive remedial teaching. In each Secondary School visited one whole class was tested, namely the lowest stream of the age group which entered the Secondary School in September 1960. The children were given a non-verbal group intelligence test to get a rough assessment of their ability from a test specifically chosen so that it did not involve any reading. Then each child was given individually a word-reading test. This survey is almost complete, one school has still to be visited. What has emerged from those already visited is that in any one age group in the Secondary School population of the borough, there are several children who can read so little that most of the work of the Secondary School is beyond them and yet who have the intelligence to learn if they can be given enough specialised help.
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In any one class there may be as few as one, two or three of these children whose educational needs are quite different from those of the rest of the class because they have not acquired the basic skills to a sufficient extent to enable them to cope with simple text books and written work. 38 Some excellent work is being done in the Secondary Schools in helping these children where staffing conditions make it possible to form small classes or to provide a teacher to take children out of their classes several times a week for extra help with their reading in very small groups. Even so there are some unfortunate children who have very little help because there are not enough facilities for remedial teaching. Also some of those who are having help and making progress could probably make much faster progress if they had more frequent or more intensive remedial help. In all there were eleven children with reading ages under seven in the age group I tested and there were twenty more with reading ages between 7 and 8 years.
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A very few of these children were of low intelligence and were near the borderline for placement in a special school for educationally sub-normal children. Many of them however showed evidence in the intelligence test of a potential ability which was within the average or low average range and would be suitable for and responsive to intensive remedial teaching. The percentage of children who need this type of help is small but each individual learning problem is severe and I feel that there is a fairly small but acute need for special remedial teaching facilities for Secondary age children in the borough to which children could be referred from the Secondary Schools if necessary. During the year five children have attended the Child Guidance Clinic for remedial teaching for an hour once a week. Four are of Secondary School age and one is a Junior School child. The junior child is a very suitable one for this once-weekly help as the problern is mainly one of influencing his attitude to reading and overcoming the enormous resistance to reading which has been built up as a result of his emotional problems.
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His reading improves more by his attitude and feelings being discussed and understood than by actual teaching and as his attitude improves he becomes more receptive and can learn better in School. One of the Secondary School children has been unfortunate enough to go through hisSecondary School career with nothing but once-weekly help here as there have been no school facilities available for teaching him to read at his age. He is just beginning to learn lore quickly, but it is almost too late as he leaves school at Easter 1963 and he definitely could have been much further on the road to becoming a literate adult if the right kind of remedial teaching service had been available for him.
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The three other Secondary Schoolchildren are very much better off as they are having extra help with reading at school two or three times a week, as well as once a week here; this combined approach works much better and they are responding, but I think they really need daily intensive help rather than short spells a few times Summary New cases tested individually 52 Children tested by group test in survey 88 Follow-up for Clinic 29 Follow-up for School 36 Remedial Education 5 Referrals to Child Guidance Clinic 6 39 Orthopaedic Clinic The number of schoolchildren referred to Mr. Whitchurch Howell, F.R.C.S., during the year was 32. I am indebted to him for the following report:- “This clinic established by Professor Gillis, and ably administered by Mr. Thomas Hynd over the years, is one of the larger ones in the Health Service. The design of the clinic, the accommodation available and its equipment are excellent, so that large numbers of patients can be seen and treated.
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Hence patients are sent here for an opinion and/or treatment most of whom are adults, with a fair number of infants and children. These include disabilities of bones and joints in the adults, and in the Infants and children some congenital deformities such as Torticollis and Club Foot. It is to be regretted that rickets and its deformities are re-appearing, especially amongst the coloured immigrants. Mr. Hynd has supplied the following figures:- (i) Orthopaedic patients seen at the consultations: Adult „ 291 Children 90 (ii) Treatment of all types of cases, both medical and surgical: 13,521 A definite liaison exists between General Practitioner and Consultant, and orthopaedic discussions between them are held at the hospital, The administration is in the hands of Mr. Hynd, who requires much more help - at least two more Physiotherapists being needed.
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He is ably assisted by Staff Nurse Marcar, with Miss Bearton as Medical Secretary and Sister Wilkinson in the X-ray Department, so that team work and team spirit are complete." HANDICAPPED PUPILS 40 A summary is given below of the ascertainment and placement of handicapped pupils during the year:- Category No. of pupils ascertained during 1962 No. of pupils admitted to Special Schools during year Total No. of pupils In Special Schools as at 31.12.62 Day Residential Day Residential Deaf - 1 - 5 2 Partially deaf - - - 2 - Blind - - - - 4 Partially sighted - - - 1 Epileptic - - - - - Delicate 7 7 1 16 4 Physically Handicapped 1 4 - 20 1 Educationally Sub-Normal 13 14 1 53 3 Maladjusted 2 - 1 - 9 Speech - - - - Dual defect (E.S.N.
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& P.H.) - - - 2 - Totals 23 26 3 99 23 FAIRCROSS SCHOOL At the end of 1962 there was a total of 176 children attending Faircross School, This school is divided into three sections - Open Air, Physically Handicapped and Educationally Sub-Normal, and the children are admitted from Dagenham, East Ham, Ilford, South Essex and Romford, as well as from Barking. The following table shows the distribution:- Open-Air Physically Educationally (Delicate) Handicapped Sub-Normal Barking 15 24 54 Dagenham 9 - 3 East Ham 13 7 Ilford • - 35 Romford 10 - 5 South Essex - - 1 It will be seen from the above that some districts possess their own Special School, e.g. has a Physically Handicapped School which does not admit delicate children and it also has an E.S.N.
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School from which we take an overflow; East ham has an E.S.N. School and Ilford has a Physically Handicapped school which admits delicate children. The Physically Handicapped and Open-Air Sections are taught together in one Part of the school and the Educationally Sub-Normal in a different part E.S.N. Section During the year 15 children left the E.S.N. Section on ceasing to be of compulsory school age (4 Barking and 11 out of district) - all were recommended as requiring care or guidance after leaving school. Two Barking children were found to be unsuitable for education at school and recommended for action in accordance with Section 57 of the Education Act 1944. 41 One Ilford child returned to an ordinary school and one Ilford child was allowed to leave at the age of 15 years as he was no longer considered to require special educational treatment One Romford girl was transferred to the Open Air Section and 5 Romford children transferred to the Havering Grange E.S.N.
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School when it opened in September. Open Air Section During the year 15 children (4 Barking and 11 out of district) were no longer considered to require special educational treatment • 12 returned to ordinary schools and 3 aged 15 were allowed to leave school. In addition, 3 children (1 Barking and 2 Romford) were tranasferred to schools for Educationally Sub-Normal pupils, 1 Romford child was admitted to a Residential Special School and 1 Barking child was recommended for Home Tuition. Barking Junior Training Centre, Castle Green This training centre has about 80 children on the register and the staff who are dedicated to the work, endeavour by kindness and persuasion to encourage any progressive traits displayed by their pupils to be developed to the greatest extent. Patience is a necessity in this labour of love but the staff feel rewarded when the pupils learn to conduct themselves with increasing confidence and self-reliance.
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The older girls wish to copy girls in a factory and so for a certain number of hours during the week, they make pot scourers for financial gain. Convalescence During 1962, 87 children benefited by being sent away for a convalescent holiday. These children go away, in the first instance, for two weeks, though this period may be extended at the request of the medical officer or of the Matron of the home to which they have been sent. The homes are situated at Bournemouth and in Devon, and many of the children are sorry to come home aa they have had such a wonderful time. Apart from an improvement in their physical condition they become more mentally stable and more able to withstand the difficulties of school. SCHOOL HEALTH STATISTICS FOR THE YEAR 1962 Total (All Schools) 1.