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After joint consultation with the neighbouring Boroughs of Havering, Redbridge, Newham and Tower Hamlets, the following schedule of immunisation has been adopted:- Age Vaccine 4 months 1st dose Diphtheria, Pertussis, Tetanus and oral polio 6 months 2nd dose Diphtheria, Pertussis, Tetanus and oral polio 12 months 3rd dose Diphtheria, Pertussis, Tetanus and oral polio 15 months Measles vaccination 18 months Smallpox vaccination 4½ - 5 years (a) 4th dose Diphtheria, Pertussis, Tetanus and oral polio. (b) Smallpox revaccination. 13 years B.C.G. (anti-tuberculosis) On leaving school (a) Tetanus Toxoid and oral polio (b) Smallpox revaccination.
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31 The new schedule was introduced with effect from 1st November, 1968 so that it will not affect the statistics of vaccination and immunisation to any appreciable degree this year. VACCINATION AGAINST MEASLES Measles is a very common virus infection, affecting practically everyone during the first 10 years of childhood. The complications of measles are also quite a significant cause of ill-health in children. Ear infections occur in 25 per 1,000 and severe infections of the respiratory tract in 38 per 1,000 cases. Neurological complications (convulsions, encephalitis) occur in 4 per 1,000. Measles encephalitis may cause severe permanent mental and/or physical handicap. In April 1968 it was decided, that a safe and effective measles vaccine should be used to protect children against this virus disease.
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Vaccination was initially offered to children susceptible to measles who were between the ages of 4 to 7 years and gradually extended to all children aged 15 years and under. Posters were displayed at strategic locations. A letter was sent to the parents of every child known to the Health Department. In addition a health education exhibit at the Dagenham Town Show was devoted to the topic of measles vaccination. By the end of the year 4,021 children had been protected against measles. The results of the campaign has been dramatic. The expected epidemic of measles in the Autumn and Winter did not occur. The number of cases of measles notified to the Health Department for the year 1968 wa6 175, a very substantial decrease indeed. MEASLES NOTIFICATIONS - 1958 - 1968 Dagenham Barking Borough Council Borough Council 1958 329 267 1959 2,038 896 1960 23 36 1961 1,
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965 1,112 1962 214 135 1963 1,045 861 1964 701 131 London Borough of Barking 1965 2,158 1966 1,039 1967 1,630 1968 175 The following statistics relate to persons protected at Council Clinics or by general practitioners during 1968: Vaccination against Smallpox Age at date of vaccination or re-vaccination Vaccinated Re-vaccinated under 1 year 82 - 1 year 1,295 1 2 - 4 years 397 6 5-15 years 211 96 Total all ages 1.985 103 32 Whooping Cough Immunisation Year of Birth Primary Immunisation Children who received a booster dose 1968 769 1 1967 1,
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185 563 1966 109 970 1965 34 152 1961 -6k 59 351 Others under age 16 10 49 Total all ages 2,166 2,086 Diphtheria Immunisation Year of Birth Primary Immunisation Children who received a booster dose 1968 771 1 1967 1,193 576 1966 118 1,023 1965 44 182 1961 -6k 251 2,140 Others under age 16 94 897 Total all ages 2,471 4,8l9 Tetanus Immunisation Year of Birth Primary Immunisation Children who received a booster dose 1968 773 1 1967 1,198 577 1966 118 1,028 1965 47 185 1961 - 6k 314 2,24l Others under age 16 560 1,308 Total all ages 3,
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010 5,340 33 Poliomyelitis Vaccination Year of Birth Primary Immunisation Children who received a booster dose 1968 769 1 1967 1,202 557 1966 120 941 1965 44 146 1961 - 64 245 1,959 Others under age 16 134 388 Total all ages 2,314 3,992 B.C.G. VACCINATION B.C.G. vaccine has been in use for over 48 years. It is a safe and very effective method of protecting the individual against tuberculosis. Extensive trials in England and Wales have 6hown that it provides 80% protection against subsequent tuberculous infection. The protection is long lasting and remains substantial for 10 or more years after vaccination. In spite of the beneficial results of vaccination the number of parents accepting B.C.G. vaccine remains low.
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Certainly a major factor in the reluctance to accept vaccination is a fear of the needle. A relatively new painless and rapid method of B.C.G. vaccination is by the use of an intradermal jet injector where a jet of air under pressure replaces the needle. Initial results suggest that it is an effective and highly acceptable method of B.C.G. vaccination. During the year 1968, 1,244 children were given B.C.G. vaccine, an increase of 219 over 1967. The number of 13 year old children in the Borough is 2,300. 164 pupils (11%) had a positive Heaf Test and were referred to the Consultant Chest Physician for chest radiography. In addition 92 contacts of tuberculosis were vaccinated by the Chest Physician.
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34 FAMILY PLANNING SERVICE Family Planning advice has been available at certain Council Clinics and at the Five Elms Out-Patient Department for many years, and was provided either by Council staff or through the Family Planning Association. On 1st April, 1968 the National Health Service (Family Planning) Act, 1967 came into effect. This Act empowered local health authorities to provide family planning advice and supplies to any persons who need them on social as well as medical grounds. After discussions with interested parties, the Council approved a scheme whereby the Family Planning Association was invited to augment their existing service in the Borough and replace the Council's existing limited service for providing birth control facilities for medical cases. At the end of the year Family Planning Clinics were being held as follows:- Annie Prendergast Clinic - Wednesday 6.30 p.m. - 8.00 p.m. Central Clinic - Friday 7.00 p.m. - 8.30 p.m.
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Five Elms Clinic - Tuesday 7.00 p.m. - 8.30 p.m. Thursday 6.30 p.m. 8.00 p.m. Thames View Clinic - Tuesday fortnightly - 2.30 p.m. - k.00 p.m. Consideration was given during the year to the possibility of instituting a domiciliary service in special cases, and it was decided to implement this service should the necessary finance be available in the following financial year. 35 PREVENTION OF ILLNESS, CARE AND AFTER-CARE HOME NURSING SERVICE This year the number of staff providing the Service remained the same throughout the year, with the exception of short periods when replacement staff were being selected. There was an increase in the number of patients cared for and within this number, the increase of elderly and chronic sick, and long term sick.
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There were one hundred more such patients admitted to the books in this year than in 1967, in the old Dagenham area alone. Still on a progressive note, it is now hoped to start a bath attendant service in the New Year. This has been a long awaited and much needed service. The attendants will visit patients who, although in need of some help with bathing, do not need real nursing care as such. The patients will still remain under the supervisory care of the home nurse. This service will to some extent help to relieve the nurse, so that she can devote more time and attention to the ill patient. The Marie Curie Day/Night Service which is for the care of patients suffering from Cancer, met with difficulties this year. This is very regrettable because in the past years many patients and their relatives have received much comfort and help from these very noble attendants.
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It has been found that this is spasmodic work and for this reason many of the 'sitters' have left the service for more regular employment, and therefore, a more regular wage. However, the service is still in existence and still making a very valuable contribution. Statistics Total number of persons nursed during the year 2,035 Number of persons who were aged under 5 at first visit 8 Number of persons who were aged 65 or over at first visit 827 LOAN OF SICK-ROOM EQUIPMENT Patients being nursed at home may, on medical recommendation, be loaned a wide variety of equipment to assist in their care. Bulky items are delivered to patients' homes, smaller articles are collected from the health department by relatives. 2,362 articles were loaned during the year and 4,035 items were out on loan at the end of the year. In addition, 35,400 disposable pads for incontinent patients were issued.
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The disposal of these pads has not given rise to any major difficulty up to the present, although their increasing use may call for special arrangements in the future, particularly in smokeless zones and in centrally heated blocks of flats. Where patients have not been able to dispose of the pads, this has been arranged at the destructor plant. Following advice from the Ministry of Health in August 1966, the sick-room equipment loan scheme was extended to include the provision of waterproof pants and knickers with disposable linings for incontinent people. During the year, 29 pairs of these garments were issued. 36 REPORT OF THE GERIATRIC LIAISON OFFICER The Geriatric Liaison Officer reports that her work has been varied and of great interest in 1968. Closer liaison has been reached between the General Practitioners and Consultant Geriatricians, in addition to better liaison between the departments of the Local Authority concerned with the elderly.
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Home assessment visits continued, to advise on the social care of the elderly, and for the follow up observation of patients discharged from hospital, these forming a major part of the work. Talks were given to the elderly in the clubs and guilds, and at times to school-children, making them aware of the services available for the elderly. Home assessment visits are also made regarding Recuperative Holidays, and chiropody treatment when requested. Time is also taken up in finding suitable accommodation, e.g. Private Nursing Homes', Guest Houses and Rest Homes, when requested. NATIONAL ASSISTANCE ACT,1948 Section 47 Again this year, it was not found necessary to remove any person from their home as being unable to care for themselves and not receiving adequate care and attention from others. This may be due in some measure to improved co-ordination in the care of the elderly resulting from the appointment of the Geriatric Liaison Officer.
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CHIROPODY SERVICE The Chief Chiropodist reports as follows:- Central Foot Clinic. Operated single-handed by the Chief Chiropodist on Monday, Tuesday, Wednesday, and Friday, in conjunction with his duties as Chief Chiropodist. Appointments average about 10 to 12 weeks. Julia Engwell Foot Clinic. Operated single-handed by Mrs. Mann, who also attended the Senior Girl's Training Centre for one session fortnightly until the transfer of the Centre to new premises in August. Appointments range about 12 weeks, but there is provision at this clinic for a second chiropodist when staff is available. 37 CASES VISITED 1968 No. of Cases Referred by Geriatric Consultants on discharge from Hospital 196 Referred by General Practitioners 17 Referred by Consultant Physicians on discharge from Hospital 89 Miscellaneous Referrals 62 Cases revisited 393 Total 757 Porters Avenue Foot Clinic.
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Operated single-handed by Mr. Ditsell on Monday to Friday. Appointments about 10 weeks. Ford Road Foot Clinic. Operated single-handed by Mr. Dransfield from Monday to Friday. Provision is made for a second chiropodist at this clinic - which is needed in this heavily populated area - but cannot be made due to staff shortage. Annie Prendergast Foot Clinic. Operated by Mr. Freeman and Mrs. Barber (Part-time, resigned 19th August), assisted by Miss Richards (Clerk Receptionist). The Hospital Car Service based at this clinic continues to prove of great value to the elderly infirm patients who would otherwise be unable to have foot treatments. Due to the large number of cases, a second full-time chiropodist is required here. Greatfields Foot Clinic. Operated by Mr. Stenson from Monday to Thursday, but unfortunately, Mr.
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Stenson was off duty through illness from l6th October 1967 to 26th February 1968, and again from 30th May to 22nd September 1968. Although a skeleton service was provided the patients have had to wait rather a long time for treatment. Thames View Foot Clinic. Operated on Friday of each week by Mr. Stenson, but owing to Mr. Stenson's illness the clinic was closed during this period. Urgent cases were directed to one of the other clinics. DOMICILIARY SERVICE Western Area. Operated by Mrs. Morgan, who also attends the Mayesbrook Old People's Home for one day fortnightly. The demand for domiciliary service is rapidly growing as our elderly patients reach the stage when they are no longer able to travel to their respective foot clinics. We need more full-time staff to cope with the need for home treatment. Eastern Area. Operated by Mr.
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Freel (Part-time Chiropodist), who does four sessions weekly. This is a very large area, and we are quite unable to satisfy the demand for treatments. The Hospital Car Service operating in this district does, however, help to accommodate the urgent demands providing the patients are able to get in and out of the cars. There is an urgent need for more staff in this section, but recruitment is difficult because of shortage of qualified staff. OLD PEOPLE'S HOMES Mayesbrook. Attended by Mrs. Morgan for two sessions every fortnight, and by Mr. Fenton (Part-time Chiropodist) one session monthly. Saywood Lodge. Attended by Mr. Fenton - one session fortnightly. The Lawns. Attended by Mr. Fenton - one session fortnightly. Riverside. This new Home is attended by Mr. Fenton every two weeks as from 6th April.
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SENIOR GIRL'S TRAINING CENTRE Attended by Mrs. Mann fortnightly until the Centre transferred to Gascoigne Road. Her last visit was on 3rd August. GENERAL REMARKS All our foot clinics and domiciliary sections are overloaded with work. Appointments range about 12 weeks in clinics, while the waiting time for domiciliary appointments is much longer; so that in the event of staff absences due to holidays or illness, there is no possibility of providing replacements, except by causing extended disruption at some other point or sections of the Service. 38 Treatments for the year Children Adults Total Sessions 0-5 5-16 O.A.P.
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Others A/N P/H Central 23 139 1,913 91 4 15 2,185 374 Julia Engwell - 24 2,287 - - 31 2,342 404 Porters Avenue - 33 2,549 3 1 14 2,600 430 Greatfields - - 1,320 - - - 1,320 226 Thames View - 15 340 - - - 355 56 Ford Road 5 332 3,155 - - 9 3,501 452 Annie Prendergast 4 321 2,505 8 1 664 3,503 551 Total 32 864 1.4,069 102 6 733 15,806 2,493 Old People's Homes Adults Total Sessions O.A.P.
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P/H Mayesbrook 250 - 250 38 The Lawns 189 - 189 23 Saywood Lodge 213 - 213 24 Riverside 197 - 197 21 Total 849 _ 849 106 Domiciliary West 1539 113 1,652 607 East 300 800 Senior Girls' Training Centre 58 58 8 Grand Totals for the Year Section Number of Treatments Sessions Worked Clinics 15,806 2,493 Old People's Homes 849 106 Domiciliary 2,452 607 Senior Girls' Training Centre 58 8 Total 19,165 3,214 39 MEDICAL EXAMINATION OF STAFF The trial scheme of invigilation by questionnaire of the health of new entrants to the Council's staff outlined in ray report for 1967, continued during the year, and after review at the end of 12 months in August 1968, it was decided to adopt this system for the future.
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During the year 879 questionnaires were submitted for scrutiny. 631 candidates were approved without further enquiry, and 27 were accepted after enquiries had been made and without medical examination. The following examinations were carried out:- No. of persons medically examined 534 No. of persons found to be unfit 34 No. of persons accepted conditionally 44 No. of persons examined in connection with sickness payments 41 No. of persons examined for other authorities 6 No. of persons examined by other authorities 29 No. of Chest x-rays arranged in connection with medical examinations 392 REHOUSING ON MEDICAL GROUNDS In order that every person who considers himself eligible for rehousing on medical grounds is treated with equal fairness, one of my medical officers (the Deputy Medical Officer of Health) is responsible for investigating the medical histories of all applicants.
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This is a breakaway from the usual pattern, whereby the doctor receives housing reports and medical/social reports from the public health inspector and health visitor respectively. All information (i.e. housing details from Housing Department and medical recommendation from a doctor) is placed in front of my Deputy, and where it is not possible to make a decision from this information, he will visit the person in his home. Statistics Total number of applications 280 Number of families visited 101 Number recommended for rehousing 32 All the applicants with young families were already on the Council's list for rehousing either by virtue of overcrowding - the majority - or because of clearance areas, and therefore overcrowding of itself cannot be considered as a medical reason. The other main group of applicants were retired pensioners, who found their present accommodation physically unsuitable because of increasing infirmities. The most frequent problem was the difficulty in climbing stairs Often it is necessary to climb four flights of 12-14 stairs to reach their accommodation.
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40 GERIATRIC CLINIC - Porters Avenue Clinic A Geriatric Clinic opened at Porters Avenue Clinic in 1968 and five courses were held in that year. Each course lasted six weeks and the number of attendants was limited to 12-15 persons. This seemed to work very well, in that, smaller groups helped to form a more intimate atmosphere. At each session films were shown and talks were given about nutrition, footcare, social services, accidents at home and other topics which seemed to be of interest to the group. The participants were offered a medical examination if they wanted one. At the end of each course a film about exercises for the elderly was shown and discussions were held about the benefits of the course. 45 persons asked for a medical examination but only 43 were examined since 2 were under hospital investigation at the time.
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The medical records revealed some data which may be of interest; 43 Total number examined 28 Married and living together 15 Males 11 Females and 1 Male living alone 28 females 3 Females living with relations Ages: 66-81 years, except for one couple aged 56 and 57 both under treatment for "nervous breakdown" for years. 30 consulted G.P.'s regularly or very recently, 9 for longer than three months. Amongst them was a lady with a blood pressure of 240/l40 and arrhythmic pulse of 120 per minute. She had not seen her G.P. in the last two months because she had been feeling "very well indeed". 4 had not consulted their G.P.'s for more than one year. 12 were overweight, 8 significantly so (more than 25%) 7 were underweight but not seriously 4 were anaemic, 1 seriously (hb 6l%).
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She had a vaginal haemorrhage only two days before the medical examination and although she went to see her G.P. a few weeks before, she did not bother on this occasion. Mild deafness was surprisingly not common but 8 were so deaf that it interfered with normal life. 3 have had National Health Hearing Aids but in one case it was so useless that the patient did not bother to wear it. This gentleman was sent to Oldchurch Hospital and his hearing aid was exchanged. The other patients who were in need of them were also fitted at Oldchurch Hospital. Affections of Joints of varying severity 18 Bronchitis 12 Gastro Intestinal disorders 13 1 ca. of Thyroid - 25 years ago 1 ca. Uteri years ago 1 Basal cell ca. still under treatment. Previously had ca. of bowel. 1 ca. Ventriculi several years ago and ca.
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Mammae - under Hospital care. Mental Illness 7 (have been or still are under treatment for depression) Epilepsy 2 (controlled) T.B. 2 (one is still attending the Chest Clinic but the other one has been discharged) 41 ADULT TRAINING CENTRE SKETCH PLAN 42 CAPITAL BUILDING PROGRAMME INTRODUCTION In dealing with capital projects it is only right that mention should be made of the difficulties which exist in a town such as Barking where there is a great shortage of building land and where the ever-pressing demands for housing sites have to be reconciled with those for other civic projects. It was fortunate that the redevelopment of the Central and Gascoigne Areas of the town presented an opportunity for comprehensive planning to be projected and implemented. It is a very heartening sight to see old properties being swept away and their place being taken by new housing enclaves, schools, health service projects, etc.
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The mental health service is fortunate in being allocated excellent sites for projects within this redevelopment area. Adult Training Centre During the summer vacation for trainees in 1968 this Centre situated in the Gascoigne Redevelopment Area was handed over by the contractors and by the time the autumn term began in September the new centre with its 120 places was ready to function. It was formally opened as the Barking Adult Training Centre on the 9th November, 1968 by the Mayor of Barking. A sketch plan of the centre is given on page 42. Because this is the only projected adult centre for the Borough provision has been made for the structure to be built so as to take a first floor extension at a later date.
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A pleasant feature of this project was the close collaboration which was accorded by the Borough Architect's Department to Health Department staff who were able to reconcile as far as possible the practical needs of the centre from a functional point of view with the difficulties of the architectural and other specialist staff who had to design within financial limits and the restrictions imposed by the site, etc. It is so easy in theory to draw up a time and motion pattern for the day to day routine of the Centre and quite another thing to put it into practice. I am happy to record that the centre has proved truly practical and is greatly appreciated by staff and trainees. The trainees themselves show great enthusiasm for the amenities and curriculum of the centre and for example with great gusto but with disciplined attention they evacuate the building in 2 minutes when fire drill is imposed by an unexpected fire alarm signal.
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With the opening of the new Centre it was possible to transfer all trainees from the Gale Street Annexe, close the small purpose-built and heavily over-crowded Adult Centre at Osborne square, and bring back all our trainees still farmed-out at the Redbridge Adult Centre. Sheltered Workshop With the closure of the Osborne Square Centre which was originally designed as a 24 place Advanced Training Centre, certain works were put in hand to convert it to a Sheltered Workshop for high grade mentally sub-normals. The training kitchen-cum-laundry was converted to a cafeteria style dining room and the dining/cum recreation hall was wired up as a workroom. The conversions allow better storage facilities and enables up to 30 trainees to be accommodated with necessary equipment. 43 The main aim of this workshop is to give a more concentrated training to selected trainees including those on the borderline for placement in open employment, and to encourage them to earn a higher wage than would be possible in an ordinary training centre.
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It is hoped that some cases will progress to open employment including some of those who previously found such employment beyond them by reason of immaturity, including lack of work habit. It was agreed that all the trainees placed at the Workshop would receive every encouragement to be self reliant including being able to travel to and from their homes on their own. Where trainees have need to use public transport their fares are paid. Prior to the inception of this scheme consultations took place with D.R.O.'s of the Ministry of Labour and staff of the Youth Employment Service who had a particular interest in the welfare of young people leaving Bentry School for the educationally sub-normal. By the end of the year, despite the 'pull' of the 'glamour' of the magnificent new adult training centre, the workshop with a small but enthusiastic staff had got under way and had begun to seek and obtain fresh contacts for work in competition with the other training centres located in neighbouring boroughs as well as our own Adult Centre.
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Hostel for the Mentally Sub-normal At the beginning of the year it was a great comfort to know that a start had been made upon this project which is situated in the Gascoigne Redevelopment Area at the junction of Cobham and King Edwards Road. This hostel will provide 25 sorely needed places but it will only meet about half the known need. It was agreed therefore, that in view of the proposal to close York House as a Nurses' Home in the reorganisation of the Domiciliary Midwifery and District Nursing Service that it should be adapted to provide a second hostel for the Mentally Sub-normal in the Eastern end of the town. Work of the Mental Welfare Officers During the year 318 patients were referred to the mental health service.
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Mentally Mentally I11 Sub-Normal Referred by general practitioners 1 Referred by hospitals on discharge .98 3 Referred by hospitals after or during out-patient or day treatment 38 2 Referred by Local Education Authority 3 25 Referred by police and courts 3 1 Referred by other sources:e.g. neighbours, relatives, Ministry of Social Security and other social and welfare agencies, inward transfers from other areas 89 12 274 44 44 Work of the Mental Welfare Officers contd.
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Mentally Mentally 111 Sub-Normal Number of persons receiving community care at the end of the year 217 384 Number of persons attending day centres 37 182 Number receiving residential care 6 18 Number of admissions for temporary residential care to relieve the family 1 23 During the year the following admissions to mental hospital were dealt with by the department: Informal 63 Compulsory 71 Via Court 7 Castle School The year started with 60 names on the register, and 9116 attendances were made during the year. Outings and visits of observation A group of older children visited The Tower of London, whilst other groups visited Valentines Park, Barking Park, Mayesbrook Park, Brentwood Zoo and an Essex Farm in conjunction with classroom projects. Regular social training visits to the shops were made. The children had an outing to Shoeburyness and they also went to London to see Cinderella on Ice. Twenty four children spent a week's holiday at St.
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Mary's Bay, Dymchurch. An average of 10 children received weekly swimming instruction and most children took part in a weekly session of Physical Education. Both these lessons were held at the Barking Regional College of Technology. Students We received one Student from the National Association of Mental Health and two from Chiswick Polytechnic for 6 weeks practical placement. Visits of observation were made by Students on Teacher Training Courses Groups of older pupils from Fairlop Secondary Modern School. Groups of 6th Formers from Eastbury Secondary School. Students from St. Bartholomew's Hospital. Two overseas visitors. Visitors The school received visits from Councillors, a representative of the Department of Health and Social Security, a party from Chiswick Polytechnic, another from the National Association for Mental Health and also many members of the public. 45 The children enjoyed a visit from the "Safety Sard' Police demonstration. Captain Gibbons of the S.S.
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'Arlanza' paid us two social calls during the year. Social Activities The children put on a Christmas play at St. Margaret's Hall which was well supported by parents, they had also, an excellent Christmas Party complete with Father Christmas. A Social Evening for parents was held during June. Staff Mrs. Smith attended a Day Release Course for Teachers of the Mentally Handicapped, and Miss Green attended a Five day Workshop Course. We lost the services of Miss Mitson when Mrs. MacKenzie, who successfully gained her Teaching Diploma, returned in July. Miss Higgins left to get married. The School Medical Officer made regular visits throughout the year, and the Speech Therapist attended for one session per week.
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Mental Health Week - 10th to 15th June, 1968 During Mental Health Week, the theme of which was 'Targets for Tomorrow' our establishments for the sub-normal were open to the public and a special exhibition was staged by the Porters Avenue Day Centre where a film show was also arranged. A shop window display was set up at 70 - 72 Ripple Road, Barking. Holiday Play Centre To provide some relief to parents during the long summer holiday, a Day Holiday Play Centre was held at Castle School from Monday to Friday for the two weeks, 19th - 30th August, 1968. The supervision of the Centre was undertaken by a lady resident in the Borough, who is experienced in the work of a Training Centre and additional staff was recruited, including students of Teacher Training Colleges and mothers of the trainees. This Centre was attended by 37 trainees - junior and adult.
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Residential Accommodation - Maisonette This accommodation consisting of two single bedrooms and one double with communal kitchen and lounge, continued to be fully occupied by four patients during the year under the supervision of the Mental Welfare Officer. Voluntary Associations Annually the Borough Council makes a contribution to the local voluntary associations, viz. the Dagenham Association and the Barking Association for Mental Health. The Dagenham Association holds monthly meetings with speakers to stimulate a public interest in mental health and gives financial aid to the mentally ill within the Borough. 46 The Barking Association holds a weekly club for the mentally sub-normal and their relatives, arranges a Christmas party to which our trainees are invited, and has a holiday bungalow at Clacton for self-catering holidays for the families of the sub-normal. Sheltered Workshop The Workshop opened in September 1968 with a staff of three Instructors including the Centre Manager, Mr.
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C. W. Hare, and 13 trainees (7 male and 6 female) the object being to train suitable educationally sub-normal adults for open employment. With this in mind, it was necessary to commence with a programme that assessed each individual as to his capabilities to understand figures, measurements, angles and written instructions as well as ability to use machine and hand tools. This was done for the first few weeks after which the trainees were given a free hand to make articles to specified sizes. After this we were able to go ahead with articles designed for sales of work. Table mats, tea pot stands, key racks and tea trays were produced. Of the latter - a good selling article - approximately 400 were made with a cash value of £ 90, and further orders were obtained for 300 trays for the following Christmas. Contract work was also undertaken during this period for local firms which included labelling of advertising literature (120,000 copies) and plastic assembly and inspection.
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Factory practice and employee discipline formed the basis of the training given on production lines. Attendances from September to December 1968 totalled 732. Porters Avenue Day Centre The number of staff at the Day Centre was increased when Mrs. Blakeley commenced duty as Instructor, having previously worked in another Centre. The scope of the Day Centre was immediately widened, affecting its social aspects, craftwork, industrial contract, and domestic activities, consequently the number of referrals increased. This tendency towards the increasing number of referrals continues and the assistance given by voluntary helpers during normal Centre hours and on special occasions has been organised accordingly by Centre staff. Such voluntary help has proved necessary and is much appreciated. The support shown by these good people has however, clearly defined the need for another full-time member of staff in the future. The Day Centre continues to give support with individual problems.
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Typical instances include personal financial management, appointments with dentists, clinics, etc., job interviews, child care, family planning, and general family problems, to name but a few. It has been found necessary to offer a wide range of activities within the Day Centre, to meet the many and varied needs of its members. They include:- Twelve different crafts Industrial contract work Simple general repairs Display stands Simple dressmaking Home produce gardening Typing and basic office procedure 47 Educational Lectures by Dr. W. H. G. Bathara, M.R.C.S., L.R.C.P., D.P.H. Series of illustrated lectures arranged by the Health Education Section. Reading and simple number work. Weekly group discussions. Domestic for Housewives Budgeting, shopping, cooking, tea making. Cleaning, personal laundering with individuals when appropriate.
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Outings this year covered river and sea barge sailing with centre members participating in the actual sailing of the vessel, West End theatre performances, and a coach trip through the Essex countryside. STATISTICS 1968 Cases referred during year: By Hospitals 17 ,,General Practitioners 7 "Hospital Social Workers 4 "Mental Welfare Officers 17 "Child Guidance Clinic 1 Referred, did not attend 3 TOTAL 49 Number re-admitted to Hospital 17 " retained in Hospital 2 " returned to Centre after treatment 9 " rehabilitated and returned to work 8 Patients who attended regularly 21 Total number of attendances 8,654 ADULT TRAINING CENTRE The comprehensive facilities offered by the new building in Gascoigne Road, Barking, enabled a wider variety of activities to be undertaken by trainees.
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Five firms supplied work which included closing plastic caps, stripping electric motors for re-wiring, preparing hats and novelties for Christmas crackers, preparing plastic moulds for furniture and making pot scourers. Groups of trainees are regularly taken to the Sports Centre for organised games and exercises, and on an outing to Leyton for Sports Day they gained five medals for winning races,etc. Social outings to see shows in London and to see various places of interest were arranged and an outing by boat from Westminster Bridge to Hampton Court was much enjoyed by staff and trainees. A club for all trainees and parents is held each Monday evening when social activities are enjoyed, and other activities are planned. 48 Total attendances at the Centre numbered 17,049 during 1968. At the end of the year 102 trainees were in attendance. Holiday Camp Scheme Holidays for trainees at the Castle School and the Adult Centres were arranged this year again at St. Mary's Bay Holiday Centre, St.
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Mary's Bay, Kent. A party of 63 from the Adult Training Centre had a weeks holiday from 3rd to 10th May and another of 24 trainees from Castle School had a week from 13th to 20th September. Our thanks are due to the staff of the Centres who accompanied the parties and made the holidays a success. HOME HELP SERVICE (1) GENERAL (a) There has been little or no change in the general organisation and administration of this service. A very close watch has been necessary on expenditure to keep the service within the financial limit available. This has resulted in careful selection of priority cases to be served and control in the planning and replanning of duties of the Home Helps. (b) During the year there has been representation from Trade Union officials concerning:- (i) Conditions of membership, (ii) a fixed guaranteed working week for part-time employees, (iii) the performance of certain duties, (iv) the procedure for payment of wages.
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These representations led to meetings at staff and Trade Union District official level with the following result:- (i) Casual employees are now required to conform to the conditions of Trade Union membership by the fourth week of employment. (c) The weekend emergency service arrangements continued in operation but the demand for service was minimal. (d) The resignation of an Organiser in June, the delay in filling the vacancy and the subsequent appointment of a replacement Assistant Organiser in December created difficulties in maintaining the previous level of supervision.
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(2) CASE LOADS (a) Fluctuation from month to month continued and throughout the year the following cases were served:- Aged (over 65 years) = 1624 Chronic Sick = 221 Mentally Disordered = 6 Maternity = 33 Others = 8 Total 1892 49 Requests received during the year = 929 Requests not acceded to during the year for varying reasons = 140 (b) Night Attendance provided for 3 cases (3) RECRUITMENT OF LABOUR The recruitment of labour has been restricted to keep the provision of service down to the requisite economic level. Wastage and replacement as follows:- Termination of employment = 67 (1750 man hours) Commencement of employment = 82 (2107 man hours) At the close of the year the labour force stood at 230 showing an increase of 15 over the previous year.
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(4) TRAINING (a) Due to the pressure of work and demands on staff time no training for manual workers was possible. (b) One Organiser attended a London Borough Training Committee's Seminar one day per week for six consecutive weeks. (5) SOCIAL ACTIVITIES A Social Club for Home Helps has been formed and monthly meetings are held at Porters Avenue Day Centre on Wednesday evenings. Speakers and/or demonstrations are arranged on varying subjects e.g. Floral Art, Costume Jewellery, Beauty Culture, Local History, etc. and is fairly well supported. A very successful Christmas Party attended by the Deputy Mayor and Mayoress, the Chairman and some members of Domiciliary and Nursing Sub-Committee was held in December. A day's outing to Eastbourne on a June Sunday was also enjoyed. FIRST-AID TRAINING OF STAFF In co-operation with the Civil Defence Officer, a course of 9 weekly lectures in first-aid was arranged for members of the Council's staff.
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The course took place from 11th January to 7th March, 1968 and 10 members of staff were awarded the First-Aid Certificate of the British Red Cross Society. CONVALESCENCE Arrangements were made for persons recommended a recuperative holiday by general practitioners or medical officers to go away for a period, usually of two weeks, as summarised below:- Adults Children National Health Service Act: Section 22 (Mothers and Young children) - 1 Section 28 (Prevention of illness care and after-care) 39 - 50 Tuberculosis Dr. J. T. Paterson for many years the Consultant Chest Physician for both Barking and Dagenham retired at the end of 1967. Dr. Loudon and Dr. Macken continued the work during 1968, and we are indebted to them for their help during the year.
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Notifications and Deaths Under 5 years New Cases Deaths Pulmonary Meninges and CNS Other Total Pulmonary Non Pulmonary M F M F M F M F M F - 3 - - - - 3 - - - - 5 - 2 4 - - - 1 7 - - - - 15 - 15 10 - — - 3 28 2 - - - 45 - 9 4 - - 1 1 15 4 1 - - 65 & upwards 11 3 - - - 1 15 8 2 - - Totals 37 24 - - 1 6 68 14 3 - - Transferred Cases Into Borough Out of Borough ecrease 13 22 9 Tuberculosis Visiting No. of cases on Register No. of Households Involved No.
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of Home Visits made 755 624 765 Free Milk On the recommendation of a Chest Physician additional supplies of milk are made available to patients suffering from tuberculosis, and 132 patients were so assisted during the year. Adaptations of Homes to Install Artificial Kidney Machines. Advances in the technique of treating chronic renal failure with artificial kidney machines has enabled this type of treatment to be carried on in patients' own homes provided the necessary adaptations are made. A patient being treated in this way needs a room with space for a single bed and the dialysis equipment, and a sink with a good supply of water. The walls and ceiling of the room should be crack-free and washable. Special storage space is required for sterile dressings and containers of concentrated fluids. Special electrical wiring, plumbing to a sink and waterproof floorcovering may also be required.
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By Circular 2/68 dated 4th January, 1968 the Minister of Health issued a general approval to local health authorities to make arrangements for the adaptation of any dwelling or the provision of any additional facilities for installing equipment for intermittent haemodialysis and during the year two patients living in the Borough, one in a Greater London Council house, and the other in a house owned by the Corporation, had their homes adapted. 51 CO-ORDINATION OF SERVICES Co-ordination and co-operation of the Health Department services with family doctor and hospital services occurs at a number of levels. At Committee level there is cross-representation of members and officers.' For example the Chairman of the Health Committee serves on the Regional Hospital Board. The Vice Chairman among others serves on the Executive Council and the Medical Officer of Health and members of the Health Committee serve on Hospital Management Committees. Hospital Management Committee members from two Management Committees are co-opted on to the Health Committee.
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The Medical Officer of Health attends the meetings of the Local Medical Committee and a family doctor is co-opted on to the Health Committee. At officer level there are links through the Medical Officer of Health with the Hospital Medical Advisory and Staff Committees and the Medical Officer of Health serves on the area Committee of the Association of Hospital Management Committees. The Senior Medical Officer in charge of the Mental Health Section attends the mental hospital for the mentally ill weekly as do the mental health social workers. One Consultant from the hospital for mentally subnormal visits the Borough and sees subnormals at the request of the Mental Health Section. One specialist visitor (Geriatric Liaison Officer) on the staff of the Medical Officer of Health is responsibile for acting as liaison between the geriatric units - the family doctors and the Local Authority services. Health Visitors work in a health centre where a group of family doctors attend and carry Infant Welfare Clinics there.
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Apart from this there is no "attachment" of staff as such though this is under discussion by the Council. The services of Health Visitors, District Nurses and Midwives are placed at the disposal of the family doctors as requested, the contact being made through the Senior Nursing Staff. Meetings between Local Health Authority Medical Officers of Health and family doctors who carry out clinics in the area are held at which common problems and new projects are discussed. 52 SCHOOL HEALTH SERVICE There are 64 primary and 23 secondary schools in the Borough. We also have two special schools. The Bentry Special School caters for educationally subnormal pupils, and Faircross Special School for delicate and physically handicapped pupils. A unit for partially hearing pupils has been established at Eastbury Infants School.
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At the end of the year, numbers on roll were as follows:- Primary schools 16,026 Secondary schools 10,554 Special schools 302 26,882 MINOR AILMENTS CLINICS Minor ailments sessions at which a doctor was present were held at the follpwing clinics:- Annie Prendergast Friday a.m. Becontree Avenue Monday and Thursday a.m. Central Monday, Tuesday and Thursday 9-10 a.m. Five Elms Monday p.m., Friday a.m. Ford Road Monday a.m., Friday a.m. Julia Engwell Monday to Friday 9-10 a.m. Leys Monday p.m. Marks Gate Friday a.m. Oxlow Lane Wednesday a.m. Porters Avenue Monday, Wednesday and Friday 9-10 a.m. Upney Monday, Wednesday and Friday 9-10 a.m. A total of 1,813 pupils were seen during the year.
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SCHOOL MEDICAL INSPECTIONS Routine school medical inspections are carried out on:- (a) pupils entering primary school, (b) pupils in their last year at primary school, and (c) where considered necessary on pupils in their last year at secondary school. In addition, pupils entering the Borough from other areas and children found to require observation or treatment are followed up as necessary. Particular attention is paid to pupils at the special schools. Periodic Inspections Age Groups Inspected (by year of Birth) No. of Pupils Inspected. 1964 and later 112 1963 1,499 1962 905 1961 188 I960 85 1959 82 1958 369 1957 1,436 1956 657 1955 73 1954 134 1953 and earlier 679 6,219 Pupils found not to warrant medical examination 790 Other inspections Number of special inspections 2,
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222 Number of re-inspections 1,363 3,585 DEFECTS FOUND BY MEDICAL INSPECTION Defect or Disease Periodic Inspections Special Inspections Treatment Observation Treatment Observation Defect or Disease 139 194 56 23 Eyes: (a) vision 190 540 181 161 (b) squint 28 24 3 6 (c) other 12 43 8 6 Ears: (a) hearing 14 119 112 213 (b) otitis media 7 4l 6 6 (c) other 14 23 - 3 Nose and throat 74 416 53 58 Speech 30 90 60 17 Lymphatic glands 16 140 - 8 Heart 11 120 9 38 Lungs 22 160 5 31 Developmental: (a) hernia 4 13 2 6 (b)other 19 160 29 93
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Orthopaedic: (a) posture 2 34 3 3 (b) feet 87 158 17 14 (c) other 22 82 47 48 Nervous system: (a) epilepsy 3 23 3 5 (b) 10 54 26 35 Psychological: (a) development 8 68 25 50 (b) stability 12 178 106 54 Abdomen 7 26 3 10 other 54 155 114 196 54 PUPILS FOUND TO REQUIRE TREATMENT Age Groups Inspected (by year of birth) Individual Pupils found to require treatment For Defective Vision (excluding squint) For any other condition Total Individual Pupils 1964 and later - 3 3 1963 31 151 174 1962 16 75 89 1961 4 11 14 1960 7 4 10 1959
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6 4 10 1958 16 13 29 1957 57 146 196 1956 21 97 113 1955 2 2 4 1954 2 5 7 1953 and earlier 28 4l 67 Total 190 552 716 General Condition of Children Out of 6,219 pupils examined, onlyseven were considered to be of unsatisfactory general condition. INFESTATION WITH VERMIN During the year, 27,490 pupils were examined, and 65O found to require treatment. CONVALESCENT TREATMENT Pupils who are recommended convalescent treatment on medical advice are sent away for periods of up to four weeks. 49 cases received treatment during the year. EMPLOYMENT OF CHILDREN 105 pupils were examined for fitness for employment out of school hours and certificates were granted. 55 DISEASES AND DEFECTS OF EAR.
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NOSE AND THROAT A Specialist Ear, Nose and Throat Consultant attends weekly at Central Clinic. Pupils known to have been treated Received operative treatment:- (a) for diseases of the ear 12 (b) for adenoids and chronic tonsillitis 117 (c) for other nose and throat conditions 2 Received other forms of treatment 295 Total number of pupils in schools who are known to have been provided with hearing aids:- (a) in 1968 2 (b) in previous years 8l ORTHOPAEDIC AND POSTURAL DEFECTS An Orthopaedic Consultant attends monthly at Leys Clinic where a wholetime physiotherapist is also in attendance. Pupils known to have been treated (a) at clinics or out-patient departments 516 (b) at school for postural defects 12 Child Guidance Clinic The temporary cover of this Clinic by locum psychiatrists continued during the year.
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Urgent representations were made to the Regional Hospital Board for increased psychiatric cover owing to an ever increasing waiting list of children for appointments, and at the end of the year agreement was obtained for the appointment of a part-time Consultant Psychiatrist for seven sessions weekly for the Board plus two sessions as psychiatric adviser to the Borough Council, making a total of nine sessions per week, and for the post to be advertised. In April 1968 the new Child Guidance Clinic premises in Shipton Close were completed offering much improved facilities and furnished and equipped to a high standard. Although not being used to its full capacity at present owing to shortage of professional staff, the new building should provide for the needs of the Borough for the foreseeable future. During the year 228 patients were seen by the locum psychiatrists making a total of 1,251 attendances. At the end of the year 38 cases were awaiting appointments.
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56 EYE DISEASES, DEFECTIVE VISION AND SQUINT Ophthalmic Specialists of the Regional Hospital Board attended weekly at Central, Porters Avenue and Becontree Avenue Clinics. Pupils known to have been treated (a) External eye diseases and other (excluding errors of refraction and squint) 24 (b) Errors of refraction (including squint) 852 (c) Number of pupils for whom spectacles were prescribed 846 ENURESIS CLINIC The statistics relating to the work of this clinic are as follows:- Appointments made Attendances New patients 101 95 Old patients 76 63 Total 177 158 DISEASES OF THE SKIN (excluding uncleanliness) Pupils known to have been treated Ringworm: (a)scalp - (b)body - Sabies - Impetigo 14 Other (plantar warts, etc.) 843 857 B.C.G.
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VACCINATION All school children from the age of 13 years are offered the opportunity to have a B.C.G. vaccination against tuberculosis, should this be indicated following a simple skin test. During the year, 1,408 children were skin tested. 1,244 were found to be suitable and were vaccinated with B.C.G. 164 pupils were found to have a positive reaction to the skin test and were referred to the chest clinic for a routine x-ray. In addition to the above, the Chest Physicians skintested 145 persons of whom 116 were found to be suitable for vaccination and 92 were vaccinated. The number of acceptances for this protection is disappointingly low, and the co-operation of parents, teachers and health staff is needed to improve matters. 57 SPEECH THERAPY The Speech Therapists report as follows:- During the year at the request of the staff the department purchased several items of testing, assessment, and attainment material for use in the Speech Clinics.
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These items were put forward as a result of the helpful refresher course which Miss Symes and Miss Delaforce were able to attend at Reading University in September, 1968. This was an extremely useful four days. We were pleased to welcome Miss Margaret Heath who commenced duty in September 1968 to our team of Speech Therapists. Miss Delaforce was able to open one session a week at the Bentry School in September. There are now eleven Speech Clinics operating in the Borough, as follows:- Miss Symes Five Elms Clinic Leys Annie Prendergast Marks Gate Oxlow Lane Miss Delaforce Julia Engwell The Bentry School Junior Training Centre at Ripple Road Miss Heath Central Faircross Physically Handicapped School The Speech Therapists have been able to do regular school visits during this year. The Statistical Returns of the Speech Therapists are as follows: 1.
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Total number of Treatments: 2,983 Total number of Non-attendances: 1,228 Total number of appointments made: 4.211 2. During the year, there were 165 new patients admitted, under the following categories of defects:- Articulatory defects 131 Language disorders 16 Stammer 13 Disorder of Resonance 3 Cleft Palate 2 Total 165 58 3. 176 patients were discharged during 1968, for the following reasons: Speech Normal 115 Transferred to other areas 14 Non-attendance, left school, etc. 44 Discharged at parents' request 1 No further progress likely 2 176 4. Number of patients on Register at 31.12.68 208 59 HANDICAPPED CHILDREN FAIRCROSS SCHOOL Mr. Holdsworth, the Headmaster, reports as follows:- "There are 115 pupils on roll. 45 children who are delicate, and 70 with physical handicaps.
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Of the total 95 are from the Borough and the remainder from the Boroughs of Havering, Newham and Redbridge. This was an interesting year for the School. The Hydrotherapy and Swimming Bath functioned to capacity, and yet I was able to offer its facilities to the children of Kingsley Hall Nursery, and to Castle School. Many visits of value both educationally, and in the general well-being of the children were undertaken this year. Notable amongst them were the visits to H. M. S. Victory at Portsmouth, and the School Journey to Shanklin, Isle of Wight, for the week 23-30th May 1968. Another School Journey is planned for May this year. The Centre will be Broadstairs, Kent. The children progressed academically, and several took, with success, the external examinations of the Royal Society of Arts, and Incorporated Phonographic Society.
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This year they are entering for the Certificate of Secondary Education Examination of the East Anglian Board. In Art the children's work was exhibited in a National Competition. In Swimming, the Amateur Swimming Association Personal Survival Bronze and Silver awards were gained - in addition to the Royal Life Saving Association Bronze Medal by several of the children. In co-operation with Schools Careers Officer, our leavers were very suitably placed in employment. All in all a very happy and successful year." BENTRY SCHOOL I have received the following report from Mr. Hurton the Headmaster:- "The number of children on the school roll dropped slightly towards the end of the year, but with the appointment of Mr. Cranmer, Senior Educational Psychologist, I am sure that steps will be taken to ascertain the extent of the problem of subnormality within the Borough. For the first time boys of the school attended the London Borough of Barking's School Camp at Hainault, and the visit was a great success.
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This encouraged us to participate in the Outdoor Pursuits Course at Trewern, near Hereford. The boys took part in Caving, Pony Trekking, Hiking, Camping and Canoeing and conducted themselves admirably. Great credit is due to Mr. Cossins who organised the visit. Great emphasis has been given to Factory Visits, Films and Talks to help our school leavers. Visits have been made to several local factories and pupils are encouraged to find their own way to the factory. Mr. Lobley, the Youth Employment Officer visited School on three occasions to talk to the pupils who would be leaving school at Easter and Summer. 60 Of the twenty-four pupils who left during the year, four were placed in Sheltered Employment at the new workshop attached to the Training Centre. Twenty went to open employment in local Factories. As is our usual custom, the school took part in the Barking Schools Music, Dancing, Drama and Speech Festivals.
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For the first time we entered Junior children as well as Seniors and both gave a good account of themselves. Our Harvest Festival Service was held on the 1st October 1968 and thanks to the splendid response by the parents, a large collection of fruit, vegetables and groceries were taken to the Church Elm Lane Flats for Elderly People. I am pleased that Dental Inspection has been carried out at the school and children requiring treatment are taken to Oxlow Lane Clinic. Speech Therapy has been recommenced and a Speech Therapist visits the school every Thursday morning. Dr. Fitzpatrick visits school every Wednesday morning and we are very grateful for her services and for the help given by Nurse Hogg. They have a genuine interest in the work of the school which is greatly appreciated. Bentry Youth Club continues to flourish and attendance is most regular. The Junior Youth Club meets on Tuesday evenings from 3*30 p.m. to 4.30 p.m. under the leadership of Mr.
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Grant. We are looking forward to the building of the new Bentry School in 1969-70 and trust that nothing will be allowed to delay this project.
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6l 62 HANDICAPPED PUPILS REQUIRING EDUCATION AT SPECIAL SCHOOLS Blind Part Sighted Deaf Part Hearing Physically Handicapped Delicate Maladjusted Educationally Sub-normal Epileptic Speech Defect Total Number of children newly assessed in year 1 - - 1 6 8 10 32 1 - 59 Number of children placed in Special Schools in year - 1 - 5 7 10 9 35 3 - 70 Number of children requiring places in Special Schools 1 1 - - 2 3 3 7 - - 17 Number of children included above whose parents had refused consent to their admission - - - - - 1 - 2 - - 3 Number of children on Registers of Special Schools at 23rd January 1969 4 13 - 34 66 67 31 210 8 - 433 Number of children receiving tuition at home or in hospital, etc.
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- - - - 1 - 2 1 _ - 4 INCIDENCE OF CONGENITAL ABNORMALITIES The notification and classification of congenital abnormalities apparent in children at birth continued during the year the following defects being noted in 32 babies:- Central Nervous System:- Anencephalus 2 Encephalocele 2 Hydrocephalus 1 Spina Bifida 4 Alimentary system Defects of alimentary system 1 Cleft lip 1 Tracheo-oesophageal fistula, oesophageal atresia and stenosis 1 Limbs Reduction deformities (amelia, hemimelia, phocomelia, etc.)
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2 Polydactyly 1 Syndactyly 3 Dislocation 1 Talipes 7 Other defects of hand 1 Other systems Vascular defects of skin, subcutaneous tissues, and mucous membranes (including lymphatic defects) 1 Other defects of skin (including ichthyosis congenita) 1 Other malformations Conjoined twins 1 Mongolism 6 63 DENTAL SERVICES I am indebted to the Principal Dental Officer for the following report School Dental Service The School Dental Service was able during 1968 to provide full Dental Treatment for any school child in the Borough receiving education from the Local Authority including those in special school. The Bentry School was given one morning per week for treatment of pupils who wish to use our Dental Clinics. The percentage of the school roll inspected in 1968 was 56% compared with 47% in 1967, the number of patients treated in 1968 was also a great improvement on the 1967 figure.
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Conservation and Orthodontic Treatment I am happy to report that there was a big increase in this field of treatment and that the trend to save teeth rather than extract them is on the increase. The amount of orthodontic treatment carried out during the year was very satisfactory. Dental Health Education The members of the Dental Staff, did an excellent job of work in this very important field of every day dental work. Dental Health talks were given to various schools and I am pleased to say that some schools asked for these talks. This is a step in the right direction, although I feel that a co-ordinated health education programme in association with individual effort is essential. Staffing The staffing position remained as in 1967. Advertisements for dental officers in The British Dental Journal did not receive any replies. I would like to thank the staff for their efforts in increasing productivity in 1968.
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Maternity and Child Welfare Dental Services Treatment was available at Dental Clinics in the Borough for expectant and nursing mothers and children under five years old. There was a slight decrease in the number of expectant mothers wishing treatment but the figures for the under fives are still very satisfactory. I have this year brought this service to the notice of parents by mentioning it in notices of school dental inspections and I hope that this method may help to increase the number of under fives wishing to have treatment. Our Dental Auxiliaries play a big part in this very important work, however, I feel that a greater degree of co-operation between the Health Education Officer, Assistant Medical Officers, Health Visitors and the Principal School Dental Officer could help to get this service into its proper place, which is in my opinion, first in priority in the dental service.
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General Comments I feel that there is need to review the Dental Services of the Borough with a view to some form of centralisation of the service to achieve essential rationalisation of treatment and administrative procedures. I also hope that in the future more use can be made of Dental Auxiliaries. With this in view I hope my suggestion made in 1967 to establish a third surgery at Oxlow Lane Clinic will be given consideration, this would be one of the best ways of increasing the output of work in the maternity and child welfare section. 64 DENTAL SERVICE STATISTICS Sessions (½ days) worked 1. Sessions devoted to inspection 118 2. Sessions devoted to dental health education l8l 3. Sessions devoted to treatment 2,419 4. Sessions devoted to treatment of mothers and young children 328 3,046 School Dental Inspection 5.
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Number of pupils first inspected at school 14,601 Number of pupils first inspected at clinic 1,992 Number of pupils found to require treatment 10,464 Number of pupils offered treatment 10,464 Number of pupils re-inspected at school or clinic 252 Number of pupils found to require treatment l8l Treatment 6. Number of pupils actually treated 4,330 7. Number of attendances made 12,919 8. Number of fillings in permanent teeth 6,211 9. Number of fillings in deciduous teeth 4,900 10. Permanent teeth extracted 608 11. Deciduous teeth extracted 2,580 12. General anaesthetics given 1,295 13. Number of pupils x-rayed 250 14. Number of pupils supplied with dentures 11 Orthodontics 15. New cases commenced 60 16. Cases remaining from previous year 139 17.
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Cases completed 42 18. Cases discontinued 12 19. Number of appliances fitted 113 20. Pupils referred to hospital consultant 6 65 MATERNITY AND CHILD WELFARE DENTAL TREATMENT Expectant and Children under Nursing Mothers 5 years Numbers of Cases 1. Number of persons examined 6l 4l8 2. Number of persons treated 55 348 Treatment Provided 3. Scalings and other prophylaxis 22 206 4. Fillings 102 968 5. Teeth otherwise conserved - 97 6. Crowns and inlays 7. Extractions 83 232 8. General anaesthetics 12 117 9. Dentures provided 7 10.
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Patients x-rayed 18 2 66 REPORT OF THE CHIEF FUBLIC HEALTH INSPECTOR SANITARY INSPECTION OF THE DISTRICT (a) Nature and number of visits:- Rent Act 100 Housing and Public Health Acts:- Dwelling houses 6,519 Other premises 1,986 Overcrowding and housing applications 70 Improvement grants 9'+2 Multiple occupation 728 Bakehouses 2^7 Milkshops and dairies 136 Foodshops, markets, stalls and delivery vehicles 2,679 Cafes and canteens 533 School kitchens and feeding centres 244 Infectious disease enquiries 900 Foster mothers' premises 25 Number of complaints investigated 3»077 Noise nuisance 191 Clean Air Act:- Survey Other inspections 91 Factories 686 Offices, Shops and Railway Premises Act 2,153 Rag Flock and Other Filling Materials Act 8 Tents,
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vans and sheds 97 Pet shops 27 Hairdressers 153 Ice cream premises and vehicles 230 Houses disinfested 37 Rodent control 2,387 Other visits 4,085 (b) Notices served:- Complied with:- Statutory 125 98 Informal 1,201 l,06l WATER The water supply still continues to be satisfactory both in quality and quantity. During the year four bacteriological and chemical and six bacteriological samples were taken from the Company's mains in the borough; all were satisfactory. The water does not have any plumbo-solvent properties and no action was called fir in respect of any form of contamination. There is a piped supply inside all houses. 67 During the year the total length of new mains laid was 1,697 yards, and 615 new supplies were connected.
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The General Manager and Chief Engineer of the South Essex Waterworks Company has furnished the following report:- "Bacteriological and chemical examinations are made of the raw water, of the water in its various stages of treatment, and the water going into supply. A total exceeding 8,000 chemical, bacteriological and biological examinations have been made and all water going into supply was wholesome. Analyses have also been made of samples obtained from consumers' taps in the various parts of the Company's district, including that of your Council, and all proved to be satisfactory." SEWERAGE AND SEWAGE DISPOSAL I am indebted to the Borough Engineer and Surveyor who has supplied the following information:- (a) Sewerage The drainage system of the borough is functioning reasonably well although the capacity at times of peak flow is inadequate. Proposals for the improvement to the combined drainage system in the Western half of the borough are at present being formulated in order to alleviate considerable flooding which occurs at times of storm.
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In the Eastern half of the borough where a separate system exists, major improvements to the foul system have recently been approved by the Ministry of Housing and Local Government and it is anticipated that contract works will commence in March of this year, the contract period being some two years with anticipated progressive improvements to the system during this period. (b) Sewage Disposal Major improvements and extensions to the Council's Riverside Sewage Works were completed during last year and the works became fully operative in September 1968 and flows have now reached the design full load capacity of the works. The responsibility for the Sewage Disposal Works passes to the Greater London Council on the 1st April, 1969- SWIMMING BATHS There are three open air and one indoor public swimming pools in the borough. In addition there is a pool at the Regional College of Technology and four of the schools are provided with small pools. All swimming pools take their water from the mains of the South Essex Waterworks Company.
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Regular samples have been taken during the year apd all results were satisfactory. 68 Slum Clearance During the year four Clearance Areas were the subject of Official Representation to the Council. The total number of houses included as unfit dwellings in the four areas was 335 Three Public Enquiries were held during the year as a result of Compulsory Purchase Orders made by the Council, On 2nd January, 1968 an Enquiry was held to determine objections in respect of two houses included in the Morley Road Compulsory Purchase Order which comprised 83 unfit dwellings and six premises as added lands. A second Public inquiry took place on 19th January, 1968 in respect of 19 objections to the St. Margaret's Road compulsory Purchase Order which included 264 unfit dwellings plus added lands.
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The third Public Enquiry on 23rd October, 1968 concerned the Gascoigne Road (No.5) Compulsory Purchase Order which comprised 165 unfit dwellings and 4 premises included as added lands. Objections in respect of two dwellings were heard. All three Orders were confirmed by the Minister with slight modifications. Rent Act, 1957 13 applications were received from tenants during the year. In no case did the Council refuse to issue a Certificate of Disrepair. Undertakings to do the work were given by landlords in respect of eight properties. Two Certificates of Disrepair were issued and one objection was received from a tenant to the Cancellation of the Certificate of Disrepair. As in past years, advice was given to tenants and they were able to obtain the necessary forms at the Civic Centre. Improvement and Conversion Grants During the year five discretionary grants and 91 standard grants were approved.
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The popularity of improvement grants continued and owners are given advice and encouragement. Enquiries were received concerning properties in all sections of the Borough where the houses, though obsolescent, are still structurally sound and are able to afford suitable accommodation for many years to come. There appeared to be a growing interest in the provision of bathrooms by means of an extension structure and I have been grateful forthe ready co-operation of the Borough Architect's Department in assessing the estimates submitted with applications for Grant. Houses in Multiple Occupation 728 visits were paid to these properties during the year. Although in this borough the problem is not a major one, it has increased slightly over the past year. Fortunately there are very few properties that lend themselves to this form of occupation. During the year a house-to-house survey in areas considered likely to contain multiple occupied houses discovered some not previously known. Conditions generally were reasonably satisfactory and in appropriate cases notices were served on owners to remedy deficiencies. There are no Common Lodging Houses in the borough.
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69 Tents, Vans and Sheds 97 visits have been made by ray staff, a decrease of 236 visits on last year's figures. As the figures show, the problem is still with us but to a much lesser degree and, of course, due to rapid building on vacant sites gipsies have increasing difficulty in finding a piece of land on which to settle. It has been found, however, that once encamped on land the task of moving the vans on has become much more difficult as a result of the belligerent attitude of the van-dwellers. LAUNDRY SERVICE The service continues with a once weekly collection. The helpful, co-operative attitude of the department's drivers and the laundry staff at the Chadwell Heath Hospital in carrying out what is sometimes an unpleasant task, ensures a very satisfactory service.
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An average of 40 cases use the service at any one time, which shows a slight increase on last year's figure and one wonders how much further increase can be borne by the staff under the present arrangements. NOISE ABATEMENT ACT, 1960 The number of complaints of noise nuisance received during the year indicates that the public are becoming more 'noise-conscious' and that conditions which would have been tolerated even a few years ago are no longer acceptable. This is a welcome hardening of opinion, for only by public pressure can the increasing noise levels of urban life be stemmed. One example concerned complaints which were received from the occupiers of an office block concerning noise arising from building operations on a site adjoining which was being redeveloped. The complaints arose from the use of a pile-driver, a cement mixing machine, a compressor and pneumatic drills.
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Investigations confirmed the existence of a nuisance and, following discussions with the Contractors, a considerable reduction of noise levels was effected by the use of acoustic screens, insulating pads and additional silencers. ATMOSPHERIC POLLUTION No progress was made in respect of smoke control areas during the year. The Council felt that the extension of smoke control areas in the borough must be deferred again due to the continued financial crisis. The present position is as follows:Dagenham Order No. No. of Houses Date of Operation 1 1,000 (Marks Gate) 1st September, 1959 2 3,722 (L.C.C. Estate) 1st November, 1961 3 3,230 ( " " ) 1st November, 1962 4 4,562 ( " " ) 1st November, 1963 70 Dagenham contd. Order No. No.
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of Houses Date of Operation 5 1,542 (Chadwell Heath) 1st August, 1964 6 3,046 (L.C.C. Estate) 1st November, 1964 7 2,690 1st November, 1965 Barking 1 4,558- (1,756 L.C.C.) 1st January, 1962 2 1,864 (L.C.C. Estate) 1st November, 1962 3 2,365 1st November, 1962 4 1,728 (L.C.C. Estate) 1st November, 1963 5 2,949 (Private) 1st November, 1963 6 1,421 (L,C.C.
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Estate) 1st November, 1964 7 1,569 1st November, 1964 8 2,446 1st November, 1964 9 589 1st July, 1966 10 1,337 (L.C.C. Estate) 1st July, 1966 11' 1,976 1st November, 1966 In all 42,594 premises out of a total of 55,013 premises in the borough are now within smoke control areas. Industry has continued to play its part in the general improvement and this is demonstrated in that 139 smoke observations were carried out during the year resulting in only two contraventions. The Council take part in the National Survey on Air Pollution and continue to take readings at the eight stations in the borough. The readings are transferred to the Ministry for their use.
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RAG FLOCK AND OTHER FILLING MATERIALS ACT, 1951 There is one premises in the borough registered under Section 2 of the Act. Regular samples were taken from the premises where fillings are made and used and details are as follows Material No. of Samples Submitted for Analysis Cotton Felt 3 Kapok 3 The Analyst reported all the samples to be satisfactory. PET ANIMALS ACT. 1951 11 licences were issued during the year; the extent of the livestock in these premises is very small. During the year regular visits were paid to all premises to ensure no nuisances occurred or breaches of the licensing conditions. The premises generally are of a high standard and no statutory action was found to be necessary. PREVENTION OF DAMAGE BY PESTS ACT. 1949 During the year 725 notifications of infestations were received of which 380 concerned rats. The remaining 345 were in connection with mice.
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In addition to the above, routine inspections of the district found 115 rat infestations and 26 of mice. 71 All cases were treated by the two Rodent Operatives with satisfactory results. RIDING ESTABLISHMENTS ACT, 1939 The two riding establishments continued to operate and the staff of the Corporation of London who administer the Act on our behalf were satisfied with the manner in which they are run. No complaints from residents were received during the year. DISEASES OF ANIMALS ACT. 1950 The Corporation of London Officials are still dealing with routine prevention and during the year there were no contraventions of the Act. ASIAN COSMETICS During the year information was received from a neighbouring authority of an "Eye Cosmetic' used by Asians which had been found, upon anaylysis, to have a lead content of up to 80%. All shops in the Borough were visited but none of this commodity was found.
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Two similar cosmetics of Asian origin were found to be on sale, but the lead content of these was found to be within acceptable limits. BAMBOO FLUTES A member of the public complained to the department that a flute made of bamboo was caked on the inside with mud. The stocks at the shop were examined and found to be in a similar condition. The matter was taken up with the importers who stated that the flutes, originating from the Far East, were made from bamboo growing in swampy conditions. They undertook to ensure that all further supplies were adequately cleansed. FACTORIES ACT.
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1961 Inspections Number on Register Number of Inspections Written Notices Occupiers Prosecuted Factories without mechanical 46 47 3 - Factories with mechanical power 436 639 34 - Other premises under the Act (including works of building and engineering construction but not including outworkers' 19 71 5 1 Total 501 757 42 1 72 Defects Found Number of defects Number of Prosecutions Instituted Found Remedied Referred to H.M. Inspector Referred by H.M.
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Inspector Want of cleanliness 9 8 - - - Overcrowding - - - - - Unreasonable temperature - - - - - Inadequate ventilation 1 - - - - Ineffective drainage of floors 3 2 _ _ 1 Sanitary conveniences: Insufficient 10 16 - - - Unsuitable or defective 109 94 - - - Not separate for sexes 2 - - - - Other offences 6 3 1 - - Total 140 123 1 - 1 Outwork Number of outworkers in August list 267 Nature of work - Making, etc. wearing apparel and Christmas novelties, and boxes. OFFICES, SHOPS AND RAILWAY PREMISES ACT, 1965 The following statistics indicate the work done by the Public Health Inspectors:- No. of premises registered during the year Total No. of registered premises at end of year No.
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of registered premises receiving a general inspection during the year Offices 20 233 64 Retail Shops 34 920 189 Wholesale shops, warehouses 7 43 17 Catering establishments open to the public, canteens 2 95 35 Fuel storage depots 1 4 7 Class of workplace Number of persons employed Offices 2,881 Retail shops 4,638 Wholesale departments, warehouses 445 Catering establishments open to the public, canteens 897 Fuel storage depots 16 Total 8,877 Total Males 4,159 Total Females 4,718 During this period 37 notifications of minor accidents were received in respect of employees in registered premises. One of these was in respect of a 17 year old girl employed in a multiple store; she cut and broke a finger of her right hand whilst cleaning a bacon slicing machine which was switched on at the time of cleaning. The firm concerned was prosecuted under Section 15 of the Act and fined £30.
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and 5 gns. costs. INSPECTION AND SUPERVISION OF FOOD The number and types of food premises in the borough are as follows:- 3 Bakehouses 50 Bakers 123 Confectioners 87 Butchers l8l Cafes and Canteens 44 Fishmongers 82 Fruiterers and Greengrocers 127 Grocers 68 Licensed and Off-licensed premises 20 Multiple stores • 14 Public Houses with Restaurants These premises were subject to frequent inspection during the year when 2,954 visits were made. In addition to verbal warnings and suggestions to managements and staff during the routine visits, 125 informal notices were served upon the owners and occupiers. 397 inspections were carried out in connection with markets, stalls and delivery vehicles, and 50 informal notices were served.
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The position under the Food and Drugs Act, 1955, apart from registrations in respect of ice cream, is as follows 44 butchers' premises and 19 other food premises are registered for the preparation or manufacture of sausages or potted, pressed, pickled or preserved food. To these registered premises 377 visits were paid. 30 fish shops are registered for frying and were subject of 288 visits. 74 Milk All milk which is distributed in the area is produced and bottled outside the borough. The number of registered distributors is 104 operating from 123 premises. 136 visits were paid to dairies and distributors' premises.
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The following samples were submitted for bacteriological examination during the year:- Designation of milk Total Samples Submitted Methylene Blue Test Phosphatase Test Turbidity Test Satisfactory Unsatisfactory Satisfactory Unsatisfactory Satisfactory Unsatisfactory Pasteurised 5 3 - 3 - - - Sterilised 2 - - - - 2 - Ice Cream' The total number of registered premises selling ice cream is 193. Of these two are registered for the manufacture of ice cream. 189 visits were were paid to these premises. During the year 43 applications for the storage and sale of ice cream were granted. 41 inspections in connection with itinerant vendors were carried out.
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During the year 83 samples of ice cream were submitted for bacteriological examination; they were graded as follows:- Type Grade I Grade II Grade III Grade IV TOTAL Wrapped Ice Cream 49 10 2 - 61 Loose Ice Cream 10 8 2 1 21 Soft Ice Cream - - - 1 1 In addition to ice cream, 23 lollies were submitted for examination. All were satisfactory. Unsound Food During the year the Committee considered 28 complaints concerning unsound food bought by residents and the following action was taken:- 23 cases - Prosecutions taken 2 " Warning letters sent. 3 " - No action possible. Registration of Food Hawkers Under the provisions of the Essex County Council Act, 1952, Section 103 14 persons were registered as food hawkers during the year. The vehicles used in connection with the businesses were inspected and action taken in appropriate cases.
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75 Food Poisoning The following is a copy of the annual return submitted to the Ministry of Health:- Incidents and Cases Causative Agent General Outbreaks Family Outbreaks Sporadic Cases No. of separate outbreaks No. of cases notified or ascertained No. of separate outbreaks No. of cases notified or ascertained Notified or ascertained S. typhimurium - - - 2 1 Other Salmonellae - - - 3 1 Cl. welchii - - - - - Staph. aureus - - - - - Other causes - - - - - Cause unknown - - - - - Total - - - 5 2 Details of Food Poisoning due to Salmonellae other than S. Typhimurium Panama 3 Type of Salmonellae Reading 1 76 Food and Drugs Act,
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1955-Sampling Article Number Examined Number Adulterated Formal Informal Formal Informal Beverages - 7 - - Biscuits - 5 - 1 Blancmange - 1 - - Bread - 6 - 3 Cakes and Pastries - 6 - 2 Cake Decorations - l - - Cereals - l - - Cheese - 6 - - Chipped Potatoes, Cooked - 1 - 1 Coconut, Desiccated - 2 - - Coffee, Instant - 1 - - Condiments - 5 - - Cream - 2 - - Cream, Synthetic - 1 - - Curry Powder - 1 - - Fats - 8 - - Flour, Self-Raising - 1 - - French Dressing - 1 - - Fruit, Dried - 2 - - Fruit Drinks, Cordials, etc.