ids
stringlengths
36
36
texts
stringlengths
1
1.43k
563feeba-ccfe-4b5e-aa3d-2bcb8723fc7f
1955 - Sampling Article Number Examined Number Adulterated Formal Informal Formal Informal Beverages 1 5 - 1 Biscuits - 2 - - Bread - 14 - 10 Butter 2 3 - 1 Cakes and Pastries - 4 - 1 Cereals 1 6 - 1 Cheese - 2 - - Condiments - 1 - - Confectionery - 17 - - Cordials 1 6 - - Cream - 2 - - Custard Powder - 1 - - Dessert - 1 - - Fat 2 - - - Fish 2 5 1 - Flavourings - 14 - 1 Flour - 3 - - Fruit Juices - 13 - 2 Fruit and Nuts - 5 - 1 Fruit, Tinned - 3 - 1 Grills - 1 - - Herbs - 2 - - Jelly - 2 - - Heat 11 9 1 5 Meat,
2024899c-2254-4637-aaae-983ba1cae595
Tinned - 3 - - Medicines - 4 - 3 Milk 10 1 - 1 Milk, Tinned - 2 - - Preserves - 2 - - Puddings - 2 - 1 Sauce - 5 - - Savouries - 3 - - Seasonings - 1 - 1 Soup - 2 - - Spices and Pickles - 11 - - Spreads - 4 - - Sweets 1 19 - 2 Vegetables - 11 - 2 Wines and Spirits 4 1 - - 68 Sample No. Article Formal or Informal Nature of Adulteration or Irregularity Observations 751A Bacon Grill Informal Contained two fragments of cotton thread discoloured by iron sulphide. Legal proceedings. Fined £5. and £5. costs. 7b3A Glass found in milk Informal Contained numerous glass fragments in bottom of bottle and one large piece. Legal proceedings.
a48f330a-7738-432e-ac39-67d6b901ab5e
Fined £15. and £10. costs. 764A Steak and Kidney Pie Informal Contained the remains of a very small spider. No action possible. Insect not cooked in pie. 765A Medium Sliced Loaf Informal Contained patches of burnt dough with a quantity of vegetable oil. Warning letter to manufacturer. 78lA Fresh Garden Peas Informal Contained a Laemostenus beetle. Legal proceedings. Fined £5. and £10.65 costs. 782A Orange Juice Informal Contained fragments of leaf tissue with some mould growth. Warning letter to manufacturer. 783A Iced Finger Cake Informal Contained a torn off piece of finger nail. Legal proceedings. Manufacturer fined £5. and £10.50 costs. 809A Happy Tuesday Loaf Informal Contained fragment of oily dough and traces of iron. Legal proceedings. Manufacturer fined £10. and £15.65 costs.
c27bbd5b-f488-4173-b131-3dc83cc70d82
810A Sausages Informal Bluish green bands on surface due to iron contamination. Warning letter to manufacturer. 813A Happy Weekend Medium Sliced Loaf Informal Contained streaks of discoloured dough containing traces of iron and oil. Legal proceedings. Manufacturer fined £25. and £15.65 costs. 8l4A Thin Sliced Wrapped Loaf Informal Contained a pellet of oily dough with a high proportion of iron rust. Legal proceedings. Manufacturer fined £10. and £15.65 costs. 69 Sample No. Article Formal or Informal Nature of Adulteration or Irregularity Observations 815A Butter Informal Contained a piece of stainless steel weighing about 0.5 grams. Legal proceedings. Packers fined £25. and £20.65 costs. 826A Tomatoes, Tinned Informal Contaminated with mineral oil. Warning letter.
88b463ad-a06a-40d1-9236-4ad2115fbed2
828A Back Bacon Informal Slices showed traces of products due to bacterial decomposition and had an off odour - out of condition. Legal proceedings. Manufacturer fined £10. and £10. costs. 836A Orange Juice Inform al Contained mould growth and traces of grit. Warning letter to manufacturer. 837A Happy Weekend Loaf Informal Contained particles of burnt crust. Legal proceedings. Manufacturer fined £20. and £20.65 costs. 838A Brawn Infornal Some of the pieces of meat contained starch which indicated the presence of luncheon meat. Formal sample taken - See No. 74 849A Mug of Tea Informal Contaminated with washing-up powder. Legal proceedings. Canteen caterers fined £10. and £15. costs. 85OA Sliced White Loaf Informal Contained a length of coarse string caught up in a crack in the outer crust. No action taken. String not baked in bread.
306668c9-e092-47b9-ba43-18fd58cdc1ee
854A Light Brown Kidney Beans Informal Contained 0.7% earthy matter. Imported FoodSieving of beans to be undertaken. 856A Italian Salad Dressing Mix Infornal Contained the antioxidant b.h.A. which is not permitted by The Antioxidant in Food Regulations 19b6 Imported Foodto be re-exported to Denmark. 864a Blackberries, Tinned Infornal Contained a sliver of wood - 4.5cm long. Legal proceedings. Canners fined £10. and £10. costs. 70 Sample No. Article Formal or Informal Nature of Adulteration or Irregularity Observations 865A White Medium Sliced Loaf Informal Contained fragments of a moth. Insufficient evidence for legal proceedings. 879A Alpha-Bits Informal Insufficient iron and phosphorus to justify claims. Vitamin B1 not declared in correct form. Imported Food.
6059176f-72dd-435b-8e3f-acf9725c653e
Future consignments will be prevented from entering the country unless labelling is amended. 884A Powder Nutramigen Informal Vitamin and minerals declared in form contrary to Labelling of Food Order 1953. Imported Food. Future consignments will be prevented from entering the country unless labelling is amended. 885A Powder Sustagen Informal Vitamin and minerals declared in form contrary to Labelling of Food Order 1953. Imported Food. Future consignments will be prevented from entering the country unless labelling is amended. 889A Bottle of Tablets Informal Bottle labelled '100 Soluble Aspirin Tablets' but was found to contain 16 Aspirin 300 mg tablets of the nonsoluble variety. Warning letter to manufacturer. 923A Christmas Pudding Informal Contained a small piece of plastic (polythene) material. Insufficient evidence for legal proceedings. 925A Hosta (Sweets) Informal Contained a nonpermitted red colouring matter.
3a6db682-c8d4-432f-99e4-9886723c88c3
Imported Food. Withdrawn from sale and destroyed, 931A Jumbo Loaf Informal Had a hollow in one end which extended through three slices due to a baking fault. Warning letter to manufacturer. 71 Sample No. Article Formal or Informal Nature of Adulteration or Irregularity Observations 932A Small Tin Loaf Informal Contained a sweet wrapper. Legal proceedings. Manufacturer fined £15. and £10. costs. 933A Saturdays Loaf Informal Contained brown discoloured dough. Case dismissed. No costs. 944A Sausages Informal Contained a piece of stainless steel weighing 1.05 grams. Legal proceedings. Manufacturer fined £40. and £16. costs. 947A Solid Milk Chocolate 'Santas' Informal A taint resembling paint solvent was present in some of the chocolate figures. Legal proceedings. Retailer was conditionally discharged for 12mths Costs £6.
5ca46155-3815-4fc9-9c40-2e2a779e0902
74 Brawn Formal Some of the pieces of meat contained starch which indicated the presence of luncheon neat. Warning letter to manufacturer. 75 Red Salmon Formal Misdescribed as Red Sstlmon as contents of can were of a pinkish brown colour and not red as depicted by the illustration on the label. Case pending. Further sample to be taken. 72 PREVALENCE OF, AND CONTROL OVER, INFECTIOUS AND OTHER DISEASES Notifiable Diseases (Other than Tuberculosis) Under 1 yr.
21879a15-4cdb-4bd2-8404-8d73b14767e5
1 - 2 - 3 - 4 - 5 - 10 - 15 - Over 25 yrs TOTAL Measles 3 19 26 24 22 119 9 8 4 234 Dysentery - - - - - 1 2 - 1 4 Scarlet Fever - - - 5 10 40 14 4 - 73 Diphtheria - - - - - - - - - - Acute Meningitis - - - - - - - - - - Acute Poliomyelitis:- Paralytic - - - - - - - - - - Non-paralytic - - - - - - - - - - Whooping Cough 9 5 5 4 5 16 3 1 - 48 Under 5 yrs 5-14 15-44 45 - 64 65 and over TOTAL Encephalitis,
4349a523-aa24-48da-923c-68318ed88621
Acute:- Xnfective - - - - - - Post Infectious - - - - - - Leptospirosis - - - - - - Paratyphoid Fever - - - - - - Typhoid 2 - - - - 2 Food Poisoning - 1 1 7 1 10 Malaria - 1 1 - 2 Smallpox - - - - - - Anthrax - - - - - - Ophthalmia Neonatorum 6 - - - - 6 Infective Hepatitis 1 18 27 9 2 57 Tetanus - - - - - - 73 Notified Admitted to Rush Green Hospital Admitted to other Isolation Hospitals Admitted to Other Hospitals Dysentery4 4 - Encephalitis,
c5fa248d-d224-439c-b76a-67c3e04e91eb
Acute:- Infective - - - - Post Infectious - - - - Food Poisoning 10 2 4 - Measles 234 1 Acute Meningitis - - - - Paratyphoid Fever - - - Acute Poliomyelitis:- Paralytic - - - - Non-paralytic - - - - Scarlet Fever 73 - - - Typhoid 2 1 1 - Whooping Cough 48 1 - - Malaria 2 2 - Hepatitis:- Infective 56 10 1 - Serum 1 1 - - 74 Food Poisoning The following is a copy of the annual return submitted to the Departr nt of Health and Social Security:- Causative Agent Incidents and Cases General Outbreaks Family Outbreaks Sporadic Cases No. of separate outbreaks No. of cases notified or ascertained No. of separate outbreaks No.
07cfec68-6c9c-4dd8-a834-3bb8fd1ee8c5
of cases Notified or ascertained Notified or ascertained S. typhirauriun - - - 2 6 Other Salmonellae - - - - 1 Cl.
7593f3b3-172b-4c1e-b3b5-d75482815a50
welchii - - - - - Staph, aureus - - - - - Other causes - - - - - Cause unknown - - - - - TOTAL - - - 2 7 Details of Food Poisoning due to Salmonellae other than S. Typhimurium Type of Salmonellae Enteriditis - - - - 1 Salmonella Infections (Not Food Borne) S. typhinurium - - - - - Other Saltionellae - - - - 1 TOTAL - - - - 1 Salmonella Infections Due to Salmonellae Other Than S. Typhimurium (Not Food Borne) Type of Salmonellae Salmonellosis - - - - 1 Senior Medical Officers and Public Health Inspectors were very concerned with an outbreak of 25 cases which developed from six different wedding receptions on the sane day. The caterer, a local firm, was the common denominator! having provided full services to all the functions.
331f9b6d-8e92-4c6d-a6d1-08f772956df2
However, after investigations by this and neighbouring authorities of some 500 guests, and tracing the food supplies, the line of infection wa6 located at a butcher's premises in a neighbouring borough. 75 The causative organisms, S. saint-paul, a common occurrence in poultry, was found in the shop and the practice of storing cooked and uncooked turkeys allowed for the cross contamination of the poultry served at some of the weddings. During these investigations it was noted that some of the halls used for weddings and other forms of reception were poorly equipped. It seems that the public, when seeking a cheap premises, often subject caterers to small dingy kitchens lacking hot water and suitable working surfaces. This is so prevalent that mobile caterers in fact carry their own washing, cooking and preparation equipment. The whole matter requires most careful investigation and evaluation, and I am calling for a report from my inspectors with a view to improving existing halls. 76
94ee2e1a-fbc2-4273-a5ba-0be2fe75cda8
BARK 66 LONDON BOROUGH OF BARKING THE ANNUAL REPORT of the MEDICAL OFFICER OF HEALTH and PRINCIPAL SCHOOL MEDICAL OFFICER for the year 1972 J. ADRIAN GILLET, M.B., Ch.B., D.P.H., F.F.C.M., F.R.S.H. Aldis House, 56A, Longbridge Road, Barking, Essex. Telephone: 01-594 5718 BARK 66 LONDON BOROUGH OF BARKING THE ANNUAL REPORT of the MEDICAL OFFICER OF HEALTH and PRINCIPAL SCHOOL MEDICAL OFFICER for the year 1972 J. ADRIAN GILLET, M.B., Ch.B., D.P.H., F.F.C.M., F.R.S.H. Aldis House, 56A, Longbridge Road, Barking, Essex.
d9a93f95-6f01-47f0-99e3-f0f23fdc9aec
Telephone: 01-594 5718 index Page Ante-natal Clinics 23 Care of Mothers and Young Children 23 Causes of Deaths 17 Causes of Infant Deaths 15 Child Guidance 47 Child Health Centres 24 Chiropody 40 Community Nursing Service 27 Congenital Abnormalities, Incidence of 50 Convalescence 44 Co-ordination of Services 20 Council,
25c88d85-eebd-4b05-bb03-fba8faba3158
Members of 3 Cytology Service 36 Dental Services 51 Education Committee 4 Education (Schools Sub-Committee) 5 Family Planning Service 32 Free School Milk (Provision of) 42 Geriatric Clinic 33 Geriatric Liaison Officer 32 Handicapped Children 49 Health Committee 4 Health Education 21 Health Visiting Statistics 28 Home Nursing Statistics 28 Immunisation 29 Page Infant Mortality 15 Kidney Machines 35 Kingsley Hall Assessment Centre 25 Medical Examination of Staff 35 Midwifery Statistics 28 National Assistance Act 1948 36 Officers of the Health Service 6 Play Therapy 25 Qualifications 12 Rehousing on Medical Grounds 36 School Consultative Clinics 42 School Health 42 School Medical Inspections 43 Sickroom Equipment 34 Social Services Department 29 Speech Therapy 46 Tuberculosis 38 Vaccination 29 Venereal Disease 38 Vital Statistics 14 Vital Statistics, Summary of 16 Welfare Foods 25 2.
7c542ac8-089a-4b02-b08f-571596cb9b41
MEMBERS OF THE COUNCIL (as at 31st December, 1972) Mayor Councillor J.L. JONES, J.P. Deputy Mayor Councillor M.J. SPENCER Leader of the Council Councillor J.A. BUTLER, J.P. Aldermen A.E. BALL, O.B.E., J.P. Mrs. Julia H. ENGWFLL W.E. BELLAMY, J.P. Mrs. A.M. MARTIN G.H.A. CROUCH B.E. ROYCRAFT, O.B.E., J .P. D.A.L.G. DODD, J.P. Mrs. A.R. THOMAS Councillors C.H. AYRES J J. LONGDEN Mrs. M. BALL, O.B.E. E.R. MANSELL RJ. BLACKBURN, J.P. Mrs.
8585948f-6ee7-411d-b373-aab227f680df
P.D. MILLER Mrs. E.E. BRADLEY J. MORTON Mrs. M. BREDO M.A. NESS G.A. BROOKER W.G. NOYCE, J .P. L.J. BRYANT M.J. O'SHEA S.G. COLE, J.P. Mrs. M.S. PRESTON L.A. COLLINS A.C.V. RUSHA F.L. COOMBER G.H. SHAW R.E. COSTER J .S. THOMAS, J .P. J. DAVIS L.A. THOMPSON C.J. FAIRBRASS F.G. TIBBLE Mrs. C.S.M. GODFREY, J.P. H. TINDELL R.H. GODFREY E.A. TURNER D.O.
e3aeca85-5da1-4eb2-9725-304ad838759a
GRANDISON J. CLINTON TWEED Mrs. A. HOWIF, B. WALKER H.J. HOWIE S.J. WARR P.G. JARVIS D.J. WATERS F.C. JONES D.W. WEBB Mrs. E.J. KITCHEN E.J. WHITE J.H. LAWRENCE 3. HEALTH COMMITTEE (as at 31st December, 1972) Chairman Councillor Mrs. M. BALL Vice-Chairman Vacant Members The Mayor Councillor Mrs. D.M. JONES The Deputy Mayor Councillor Mrs. P.D. MILLER The Leader of the Council Councillor J. MORTON Alderman Mrs. J.H. ENGWELL Councillor Mrs. V.H. POOL Alderman Mrs. A.R. THOMAS Councillor M.J.
eeaf9f9a-9cef-48bc-922e-b7ec5b41bd08
O'SHEA Councillor Mrs. E.E. BRADLEY Councillor Mrs. M.S. PRESTON Councillor F.L. COOMBER Councillor F.G. TIBBLE Councillor R.E. COSTER Councillor J. CLINTON TWEED Councillor Mrs. A. HOWIE Councillor S J. WARR Co-opted Members Mrs. D.L. BELCHAMBER Dr. A.F. MacDONALD Mr. J. SMITH Mrs. A.E. PRENDERGAST EDUCATION COMMITTEE (as at 31st December, 1972) Chairman Councillor A.C.V. RUSHA Vice-Chairman Councillor Mrs. D.M. JONES Representative Members The Leader of the Council Councillor CJ. FAIRBRASS Alderman A.E. BALL Councillor Mrs. C.S.
02dad639-506a-4cc5-96f7-b47545e1d51d
M. GODFREY Alderman W.E. BELLAMY Councillor D.O. GRANDISON Alderman D.A.L.G. DODD Councillor P.G. JARVIS Alderman Mrs. J.H. ENGWELL Councillor F.C. JONES Councillor Mrs. M. BALL Councillor J J. LONGDEN Councillor R J. BLACKBURN Councillor J. MORTON Councillor Mrs. E.E. BRADLEY Councillor Mrs. M.S. PRESTON Councillor LJ. BRYANT Councillor G.H. SHAW Councillor S.G. COLE Councillor H. TINDELL Councillor F.L. COOMBER Councillor E.A. TURNER Councillor R.E. COSTER Councillor D.W.
6ab2c080-ba7c-417b-bac8-16bd0138be21
WEBB Councillor J. DAVIS Councillor E J. WHITE 4. Co-opted and Nominated Members Mr. GJ.G. BEANE Mr. D.F. REED Mr. E.W. COOLEY Mr. A. RICHARDS Mr. P. GRIMES The Rev. J.W. ROXBURGH Miss M.C. GROBEL, M.A. Mrs. F. RUSHA Mr. W.E. JOUGHIN Mr. SJ. RUSSELL Mr. F.H. KING SCHOOLS SUB-COMMITTEE (as at 31st December, 1972) (This Sub-Committee deals inter alia, with the School Health Service) Chairman Councillor Mrs. D.M. JONES Vice-Chairman Councillor Mrs. C.S.M. GODFREY Members Alderman W.E.
0a613f9e-9549-466a-a653-702da3f06051
BELLAMY Councillor A.C.V. RUSHA Councillor Mrs. M. BALL Councillor H. TINDELL Councillor S.G. COLE Mr. E.W. COOLEY Councillor R.E. COSTER Mr. W.E. JOUGHIN Councillor C.J. FAIRBRASS Mr. F.H. KING Councillor D.O. GRANDISON Mr. A. RICHARDS Councillor Mrs. M.S. PRESTON The Rev. J.W. ROXBURGH 5. OFFICERS OF THE HEALTH SERVICE (as at 31st December, 1972) Medical Officer of Health J. Adrian GILLET, M B., Ch.B., D.P.H., F.F.C.M., F.R.S.H. Deputy Medical Officer of Health R. BEAVER, M.B., B.S.
8425da8e-024b-44ce-af4b-483df3316aa6
(Rangoon) D.C.H., D.P.H., M.F.C.M. Medical Officer in Senior Post H.C. GUPTA, M.B., B.S.(Bombay) D.P.H. Senior Medical Officers in Department E. KLEIN, M.D.(Naples), M.D.(Budapest) L.R.C.P. & S. M. WEIZMANN, M.R.C.S., L.R.C.P. Medical Officers in Department G.G. BENNETT, M.B., B.S., D(Obst) R.C.O.G., M.R.C.O.G. D. BURGESS, M.D.(Malta). B.Pharm. K. FITZPATRICK, M.B., Ch.B. G. MICHAEL, M.R.C.S., L.R.C.P., B.A.(Cantab) In addition 14 Medical Officers are employed on a sessional basis. Principal Dental Officer J.K.
5d7646dc-8af8-41ef-9c1a-522377762032
WHITELAW, L.D.S., R.C.S., (Ireland) Senior Dental Officer P.K. CHAUDHURY, L.D.S., R.C.S.(Eng.) Dental Officers Mrs. L. BENJAMIN, B.D.S.(Eng.) A.M. DIXIT, L.D.S., R.C.S.(Eng.) C. SUMSAWASTE, L.D.S., R.C.S.(Eng.) Senior Dental Surgery Assistant Mrs. F.B. SADLER (20) Dental Surgery Assistants Mrs. J.R. GREGORY (20) Mrs. A. SCALES (20) Mrs. J. HUNTER Miss M. SEALEY Mrs. J.C. MITCHELL (20) Mrs. M. SIPOS (part-time) Mrs. D. MURRAY (20) (part-time) Mrs. M. STRACHAN (9) Dental Auxiliary Mrs.
fb08ea12-07d2-4fb5-a54f-4c9da68f5383
E. CHARD (21) 6. Chief Public Health Inspector Mr. M R. WILLIAMS. (1), (2), (4). Deputy Chief Public Health Inspector Mr. B. SAUNDERS, (1), (2), (4). Divisional Public Health Inspectors Mr. J. ALLAM, (1), (2), (4). Mr. J. POWELL, (1), (2), (4). Public Health Inspectors Mr. C.F. BROWN. (29). Mr. C. NASH, (29). Mr. N BURTON, (1), (2). Mr. B. ORME, (29). Mr. J. COOK, (1), (2), (3). Mr. B. PETERS, (29). Mr. T.W. CLEW, (1), (2). Mr.
7f713727-d189-4a6f-af46-a29c3d85ebd6
C.C. PORTER, (29), (33). Mr. G.P. MORRIS, (29). Mr. F. SILVERTHORNE, (1), (2), (33). Mr. H.R. VAUGHAN, (29). Student Public Health Inspectors Mr. P. KING Mr. D.J. PALMER Mr. D. WOODS Director of Nursing Services Miss. E.M. CLARKE, (5), (6), (7), (38). Area Nursing Officers Miss P. BROADBENT, (5), (6), (7). Miss M. DOBSON, (5), (6), (19). Nursing Officers Miss M. TEATHER, (5), (6). Mrs. A. WARD, (5), (7), (25). Miss J.M.
bb4c7555-ddb7-4cd5-a3cf-4c4b7f4d1bf0
SMITH, (5), (6), (19). Mrs. W.D. CLEGG. (5). (6). (7). Mr. R.J. TURPIN, (5), (19). Health Visitors Miss J.D. BALDWIN, (5), (6), (7), (19). Miss O. OLOGUNRO, (5), (6), (7). Miss A.E. BOORMAN, (5), (6), (7), (19). Mrs. B. RABIN, (5), (7), (8). Miss R.D. HUTCHINSON, (5), (6), (7), (19). Mrs. B. RAMSEY, (5), (6), (7), (18). Mrs. A. KHAN, (5), (6), (7), (19). Miss D.B.
7eef6183-872d-4d41-b8bf-883b699342fd
RUDD, (5), (6), (7). Mrs. M.M. MILLER, (5), (7), (8). Miss M.F. SAVAGE, (5), (6), (7), (13). Mrs. N.M. NAGAR, (5), (7), (25). Mrs. O.J. WILLIAMSON, (5), (6), (7), (19). Miss T. O'KELLY, (5), (7), (8), (19). Miss M.D. WINT, (5), (6), (7). Health Visitor (part-time) Mrs. J. O'BRIEN, (5), (7). Sponsored Student Health Visitors Miss C.A. MANSELL, (5), (6). Miss E. McLOONE, (5), (6). 7. District Nurses Mrs. M.A.
82895a65-c68d-45f0-b73d-ef3c83d85d59
BATES, (5), (8). Mrs. Y.V. NICHOLLS, (5), (6), (19). Mrs. J.E. BIGGART, (5). Mrs. B. NOBLE, (5), (6), (19). Mrs. J.M. COTTERILL, (5), (19). Miss N. NORRIS, (5), (6), (19). Mrs. Y.A. DIGNUM, (5), (19). Mrs. M. O'RIORDAN, (5), (8), (19). Mrs. J.R. HARPER, (5). Mrs. M.Y. PARKER, (5), (19). Mrs. A. HAYDEN, (5), (19). Mrs. M. PRONT, (5). Mrs. M.G.
8c8316fa-f5c5-4071-8769-ea533b17f2af
KELLY, (5). Miss D.M. RENSHAW, (5), (6), (7), (12), (19). Mr. C.O.E. KING, (5), (10), (19). Miss R. RICHARDS, (5), (6), (19). Mrs. D.J. KITCHEN, (5), (6), (19). Mrs. A.M. ROBINS, (5), (19). Mr. R.D. LINTOTT, (5), (19) Mrs. L.M.T. SANSOM, (9). Mrs. s.w. McQuillan, (9), (19). Mrs. a.b. sarsfield, (5). Miss K.M. MOLLERUP-PETERSON, (5), (19). Mrs. E.A.
ba2f74fb-bdea-4040-a0e9-c2fd90d545cd
STIMSON, (9), (19). Mrs. M.E.M. WHATHAM, (5), (8), (12). District Nurses (part-time) Mrs. E.H. BUTCHER, (5), (6), (19). Mrs. N. FLYNN, (5), (8), (19). Mrs. E. COLGATE, (9). Mrs. A.L. HILLAS, (5), (19). Midwives Mrs. N.M. ADAMS, (5), (6). Miss J.M. HALL, (5), (6). Mrs. S.L. BRADLEY, (5), (6), (19), (26). Miss D. HEARSEY, (5), (6). Mrs. I.M. BRONNICK, (5), (6). Mrs. S.M.
b27d75a9-e7e4-4497-a450-2df08008cb4d
READ, (5), (6). Mrs. H.V. GOOBY, (5), (6). Miss P.R. SHACKLETON, (5), (6), (9). Mrs. A. GREEN, (5), (6), (19). Miss M. WALKER, (5), (6). Mrs. C.B. WATSON, (5), (6). Midwife (part-time) Mrs. M.E.R. WAINWRIGHT, (5), (6). School Nurses Mrs. E.M. McCHEYNE, (5). Mrs. P.A. PICKEN, (5). Mrs. M.C. TWOMEY, (5). Clinic Nurses Mrs. S.M.C. BARBER, (5). Mrs. L.V. NEWBURY, (5). Mrs. J.J.
ec538872-e610-4e96-bba1-8dc33a10583a
GIANOTTI, (5). Mrs. M.P. RAMAGE, (9). Miss E.A. RICH, (5), (25). Clinic Nurses (part-time) Mrs. S.J. BROWNE, (9). Mrs. R.M. LEWIN, (5), (6). Mrs. I.M. COLLINGWOOD, (5). Mrs. A. LYONS, (9). Mrs. B. CULLUM, (5). Miss. I.C. MCCARTHY, (5). Mrs. M. IIALLIGAN, (5), (6), (12). Mrs. M.E. MONTGOMERY, (5). Mrs. E.M. HILL, (9). Mrs. G. PRATT, (5). Mrs. D.L. HUNTLEY, (5).
f74dc483-a86a-4c1c-8210-f5a7af8cef17
Mrs. R.J. SCAMELL, (5), (19). Geriatric Liaison Officer Mrs. J. HARROLD, (5), (12), (28). 8. Speech Therapists Miss C.J. DELAFORCE, (16). Miss E.M. SYMES, (16), (17). Physiotherapist Mrs. A. WALKER, (24). Physiotherapists (part-time) Mrs. A. LAWRENCE, (23). Mrs. J.M. WARWICK, (23). Chief Chiropodist Mr. G.E. FENN, (11). Senior Chiropodists Mr. D. DITSELL, (11). Mrs. M.G. LEAGE, (11). Mr. N. FREEMAN, (11). Mrs. D. MANN, (11).
6acb4259-bf70-478e-86ff-0b6114a334e1
Assessment Centre Kingsley Hall Day Centre Sister-in-Chargc Mrs. K.I. DALY, (5), (6), (18). for Handicapped Children, Hobart Road, Dagenham. Health Education Officer Miss D. MILBANK, (5), (6), (7), (18), (19), (22). Assistant Health Education Officers Mr. J.T. FISHER Mrs. A.R. MARCUS, (34), (35), (36). Lay Administrative Officer Mr. F.W. KNIGHT, (1), (2). Senior Administrative Assistants Mr. F.H. MARTIN, (14). Mr. B.S. WEAVER Section Heads Mrs. P.H. FLOODGATE, Vaccination and Immunisation. Miss G.K. HARRIS, Environmental. Mrs. M.C. NEWMAN, Care and After Care.
4fc4ce3d-b3a4-4aae-a053-84cd7e33bc2a
Mr. H.J. PITT, ) -Staffing. Mr. P.K. GREEN, ) Finance and Supplies. Mr. R.G. TRUCKEL, (32). Maternal and Child Health. Medical Officer of Health's Secretary Mrs. J.M. de BRUIN, (37). 9. Section Clerical Staff Vaccination and Immunisation Mrs. M. KING Mrs. S.E. ALLEN Environ mental Mrs. E. DAVIDSON Miss N.M. TOMS Miss A.M. LYONS Miss C. WEAVER Mrs. J.W. MORGAN Rodent Operative/Driver Mr. H.J. DUFF Management, Finance and Supplies Mrs. F.E. BRAY Miss S. HAMPTON Mrs. M.R. BUSHELL Mrs. P. McMILLAN Miss V.E. CHEAL Miss C.M.
c10c566b-a8f7-4bbb-9129-63d2be355e13
SACH Miss K.I. FIELDING Miss J. WICKS Mr. R.E. WRIGHT Maternal and Child Health Miss E.A. ADAMS Mrs. I.A. PAGE Miss E.D. BROWN Mrs. V.N.F. PATIENCE Miss N.E. CLOKE Mrs. J.R. REDMAN Miss A.C. DA VIES Miss M.A. RHODES Mrs. D.M. ELLIS Miss K. RICHARDS Mrs. M.E. GODFREY Mrs. G.K. SHANNON Mrs. D.G. GREEN Mrs. G.B. STOKES Miss C.A. LINCOLN Miss D. TILSON Mrs. E.J. NEPORT Mrs. D. WILKINS Mrs. M. NOTTAGE Mrs. I.F. FRANKLAND Part-time Mrs. K. BIRD Mrs.
0a142c1b-fc98-46c9-a92b-ad3d1e5a52a2
A. McCARTHY Mrs. E. HARSENT Mrs. O.E. NASH Mrs. K.F. HEXTER Mrs. H.P. ROBERTS Mrs. S. HOPSON 10. REGIONAL HOSPITAL BOARD OFFICERS ATTENDING PART-TIME Orthopaedic Surgeon A.F. BRYSON, M.A., M.B., B.CHIR., F.R.C.S. Ophthalmologists Dr. R.F. JAMIESON, M.B., Ch.B., D.O.M.S. Dr. P. LANCER, M.B., B.S., M.R.C.S., L.R.C.P., D.C.H., D.O.M.S. Part-time Consultant Psychiatrist Dr. S.I. FAHMY, M.B., Ch.B. Royal College of Psychiatrists British Psycho-Analytical Society Ear, Nose and Throat Surgeon Miss M. MASON, F.R.C.S.
ca02ed61-e80a-4523-9494-9c693086fa33
Physiotherapist Mrs. E. OTTLEY, M.C.S.P. Other Medical Officers attending part-time K.S. HOLT, M.D., Ch.B., F.R.C.P., D.C.H. (Adviser in Child Development, Kingsley Hall) Public Analyst (part-time) J. HUBERT HAMENCE, Ph.D., M.Sc., F.R.I.C. 11. QUALIFICATIONS (1) Certificate of Royal Sanitary Institute. (2) Meat Inspector's Certificate. (3) Sanitary Science as applied to Building & Public Works Certificate. (4) Smoke Inspector's Certificate. (5) State Registered Nurse. (6) State Certified Midwife. (7) Health Visitor's Certificate. (8) State Certified Midwife, Part 1. (9) State Enrolled Nurse. (10) Registered Mental Nurse. (11) State Registered Chiropodist. (12) State Registered Fever Nurse.
e9c3fc13-91da-4215-ad36-3857ebc89456
(13) Certificate of National Nursery Examination Board. (14) Diploma in Public Administration. (15) Certificate of National Society of Children's Nurses. (16) Diploma of Licentiateship of College of Speech Therapists. (17) Diploma in Social Science. (18) Registered Sick Children's Nurse. (19) District Nursing Certificate. (20) Certificate of Examining Board of Dental Surgery Assistants. (21) Certificate of Proficiency as Dental Auxiliary. (22) Diploma in contents and methods of Health Education. (23) Member of Chartered Society of Physiotherapy. (24) Member Oslo Orthopaedic Institute of Physiotherapy. (25) Obstetric Nurse Training Course. (26) State Enrolled Assistant Nurse Certificate (Tropical Nursing), Malaysia. (27) Certificate of Royal Dental Hospital. (28) Institute of Home Help Organisers. (29) Diploma of Public Health Inspectors Education Board.
c135d5b0-8a37-4123-b2f4-8d0168138aa0
(30) University of Cambridge Teaching Certificate. (31) Ministry of Education Certificate in Physical Education. (32) Associate of the Chartered Institute of Secretaries. (33) Diploma in Air Pollution Control. (34) B.Sc. (Hons.) Nutrition. (35) State Registration of Dietetics. (36) Qualified Teacher Status (Dept. Education and Science). (37) National Examination Board, Certificate in Supervisory Studies. (38) Nurse Tutor's Certificate. 12. Health Department, Aldis House, 56a, Longbridge Road, Barking. To: The Mayor, Aldermen and Burgesses of the London Borough of Barking. As the reorganisation of the National Health Service looms ever nearer the staff view the situation with very mixed feelings indeed.
68431b76-1bd5-4047-ad45-012abb6fc298
The move to 'new' premises and the consequent divisions of the Department gave the Aldis House occupants the feeling of being isolated from the mainstream of Local Government, specially as rapid communication with the environmental health section created difficulties especially in times of crisis. It is hoped that the separation of the Health Department from Local Government in 1974 will not increase these difficulties. In the hope that these may be avoided it is suggested that the Gvic Centre should provide office accommodation and staff for the 'proper officer' of the Area Health Authority who will be responsible to the Local Authority for the control of infectious disease and environmental health advice in the new service. During 1972 the infant death rate was 15.22 as against that in 1971 which was 21.16. Health Education activities which are becoming more and more an important part of preventive medicine continued to increase during the year. One fact worthy of note is that 'Maystonisation' of the community nursing services was begun.
9af7fae4-b27e-4952-9496-79fc04141b4f
This involved a restructuring of the nursing services and the appointment of Nursing Officers, an Area Nursing Officer and a Director of Nursing Services. It was hoped to have a total of three Area Nursing Officers - one of whom would undertake duties in the training field. However, the suggestion was made by the Department of Health that two should be sufficient initially. This means that at the end of 1972 one post of Area Nursing Officer remained unfilled. Owing to pressure of work in the Environmental Health Section of the Department, it has not been possible to include in this Report matters dealt with via the Chief Public Health Inspector. These include, inter alia control of infectious diseases and food poisoning, water supply, sewerage and sewage disposal, milk supplies, hygiene of food premises, poultry inspection, inspections under the Factories Act 1971, returns of outwork, and the registration of common lodging houses. It is hoped to publish a separate account of these and other activities of this section when conditions allow.
d171d0f1-0342-475f-bb5e-d0812235a8a0
J. Adrian Gillet, Medical Officer of Health 13. VITAL STATISTICS 1972 Registrar General's estimate of residential population, mid-year 1972 158,710 Live Births: Legitimate (1,001 males, 962 females) 1,963 Illegitimate ( 65 males, 75 females) 140 Total (1,066 males, 1,037 females) 2,103 Illegitimate live births per cent of total 6.66 Live birth rate per 1,000 population 13.25 Live birth rate adjusted by comparability factor of 1.11 14.71 Stillbirths: Legitimate ( 23 males, 13 females) 36 Illegitimate ( - males, 1 female ) 1 Total 37 Stillbirth rate per 1,000 live and stillbirths 17.29 Total live and stillbirths 2,140 Deaths: Infant deaths (under 1 year) (18 males,
c577a00a-93ff-44b4-a3dc-447f4a722f43
14 females) 32 Infant death rate per 1,000 live births 15.22 Legitimate infant death rate per 1,000 legitimate live births (17 males, 14 females) 15.80 Illegitimate infant death rate per 1,000 illegitimate live births ( 1 males, - females) 7.14 Neo-natal mortaility rate (deaths under 4 weeks (23) per 1,000 live births) 10.94 Peri-natal mortality rate (stillbirths (3) and deaths under 1 week (18) per 1,000 live and stillbirths) 25.70 General Mortality: Number of deaths (1,106 males, 925 females) 2,031 Death rate per 1,000 population-crude 12.80 Death rate adjusted by comparability factor of 1.02 13.06 14.
6528fa5f-024f-4911-8e5e-73dd6e1fb5f0
CAUSES OF INFANT DEATHS Causes of Death Age at Death Total Under 4 weeks 4 weeks-1 yr. Birth Injury, Difficult Labour etc.
9fc7c81f-b33f-4b25-9091-fa5f52ae7abd
9 - 9 Bronchitis and emphysema - 1 1 Congenital Anomalies 5 2 7 Enteritis and other diarrhoeal diseases - 2 2 Other diseases of respiratory system - 2 2 Other causes of perinatal mortality 6 - 6 Meningitis 1 - 1 Pneumonia 2 2 4 Total All Causes 23 9 32 PRINCIPAL CAUSES OF DEATH (All Ages) Diseases of heart and circulatory system 706 Cancer and other malignant diseases 503 Pneumonia, bronchitis and other respiratory diseases 365 Cerebrovasculor disease and other diseases of the brain and nervous system 246 I give below for purpose of comparison the birth and death rates of Barking, Greater London and England and Wales for 1972.
e4e492c4-c32c-43ca-b809-19487e461630
Barking Greater London England and Wales Live Births (per 1,000 population) 13.3 14.1 14.8 Stillbirths (per 1,000 live and stillbirths) 17.3 11.2 12.0 Infant Mortality (per 1,000 live births) 15.2 17.1 17.0 Deaths (per 1,000 population) 12.8 11.8 12.1 15. 16. SUMMARY OF VITAL STATISTICS 1965 - 1972 Year Population Deaths *Death Rate Live Births *Live Birth Rate Deaths under 1 year Infant Death Rate 1965 172,970 1,748 13.34 2,408 14.48 40 16.61 1966 171,000 1,701 13.23 2,348 14.29 36 15.33 1967 170,100 1,
e8b9ed52-73a9-4746-bbf9-f48d3d91c68b
715 13.31 2,296 13.50 45 19.6 1968 169,520 1,857 14.46 2,307 14.15 41 17.77 1969 167,960 1,902 14.72 2,234 13.30 39 17.46 1970 166,060 1,764 13.91 2,202 13.80 27 12.26 1971 153,870 1,861 15.84 2,174 14.70 46 21.16 1972 158,710 2,031 13.06 2,103 14.71 32 15.22 * Adjusted for comparability Page 17.
e2e185f0-1201-4729-aca7-433f97cc86e8
CAUSE OF DEATH AGE AT DEATH Under 1 year 1 and under 5 years 5 and under 15 years 15 and under 25 years 25 and under 45 years 45 and under 65 years 65 and under 75 years 75 years and over Total M F M F M F M F M F M F M F M F M F 1. Cholera - - - - - - - - - - - - - - - - - - 2. Typhoid Fever - - - - - - - - - - - - - - - - - - 3. Bacillary Dysentery and Amoebiasis - - - - - - - - - - - - - - - - - - 4. Enteritis and other Diarrhoeal Diseases 2 - 1 1 - - - - - - - - - - - 1 3 2 5.
39b6734a-36b5-4a8c-a186-ba3d927a5aec
Tuberculosis of Respiratory System - - - - - - - - - - - - - 1 1 - 1 1 6. Late effects of Respiratory Tuberculosis - - - - - - - - - - - - - - - - - - 7. Other Tuberculosis - - - - - - - - - - - - - - - - - - 8. Plague - - - - - - - - - - - - - - - - - - 9. Diphtheria - - - - - - - - - - - - - - - - - - 10. Whooping Cough - - - - - - - - - - - - - - - - - - 11. Streptococcal Sore Throat and Scarlet Fever - - - - - - - - - - - - - - - - - - 12.
74823d8d-a838-458f-8b37-bcc4d5047d84
Meningococcal Infection - - 1 - - - - - - - - - - - - - 1 - 13. Acute Poliomyelitis - - - - - - - - - - - - - - - - - - 14. Smallpox - - - - - - - - - - - - - - - - - - 15. Measles - - - - - - - - - - - - - - - - - - 16. Typhus and other Rickettsioses - - - - - - - - - - - - - - - - - - 17. Malaria - - - - - - - - - - - - - - - - - - 18. Syphilis and its sequelae - - - - - - - - - - - - - - - - - - 19.
70f02431-53e9-4f9f-91cf-6a85536b018e
All other infective and parasitic diseases - - - - - - 1 - - - - - 1 - - - 2 - Malignant Neoplasm of: 20. Buccal Cavity and Pharynx - - - - - - - - - - - 1 - - 1 1 1 2 21. Oesophagus - - - - - - - - - - 4 2 - 1 - 1 4 4 22. Stomach - - - - - - - - - - 15 3 15 3 9 11 39 17 23. Intestine - - - - - - - - - - 8 9 9 12 10 7 27 28 24.
20a1c08b-0c15-4b1a-876d-11cd2ccf5c64
Larynx - - - - - - - -- - - 1 - - 1 1 - 2 1 Carried forward 2 - 2 1 - - 1 - - - 28 15 25 18 22 21 80 55 Page 18. CAUSE OF DEATH AGE AT DEATH Under 1 year 1 and under 5 years 5 and under 15 years 15 and under 25 years 25 and under 45 years 45 and under 65 years 65 and under 75 years 75 years and over Total M F M F M F M F M F M F M F M F M F Brought forward 2 - 2 1 - - 1 - - - 28 15 25 18 22 21 80 55 Malignant Neoplasm of: 25.
41d8d0de-b11f-4177-827b-33a106963aaf
Lung Bronchus - - - - - - - - 2 2 49 14 64 12 24 9 139 37 26. Breast - - - - - - - - - 1 - 15 - 13 - 7 - 36 27. Uterus - - - - - - - - - 3 - 4 - 3 - 3 - 13 28. Prostate - - - - - - - - - - - - 12 - 4 - 16 - 29. Leukaemia - - - - - - 1 - 1 1 - - 1 - - 2 3 3 30. Other Malignant Neoplasms - - - 2 1 - 2 - 2 2 30 16 24 21 7 24 66 65 31.
35d7f918-fd29-47e7-8cac-11144c882701
Benign and unspecified Neoplasms - - - - - - - - - - 1 2 1 1 1 - 3 3 32. Diabetes Mellitus - - - - - - - - - - 4 5 2 5 2 7 8 17 33. Avitaminoses and other nutritional deficiences - - - - - - - - - - - - - - - - - - 34. Other endocrine, nutritional and metabolic diseases - - - - - 1 - - - - 1 3 - - 1 4 2 8 35. Anaemias - - - - - - - - - - 1 1 - - - 1 1 2 36. Other diseases of blood and blood forming organs - - - - - - - - - - - - - - - - - - 37.
b56f39a3-f9c8-47ed-963f-b14a7ce9ae28
Mental disorders - - - - - - 1 - 1 - - 2 - - - - 2 2 38. Meningitis 1 - - - - - - - - - - - - - - - 1 - 39. Multiple Sclerosis - - - - - - - - - - 2 3 - - - - 2 3 40. Other diseases and nervous system and sense organs - - - 1 - 1 1 - 1 - 2 - 3 2 2 2 9 6 41. Active Rheumatic Fever - - - - - - . - - - - - - - - - - - 42. Chronic Rheumatic Heart Disease - - - - - - . - - - 3 4 1 2 1 4 5 10 43.
b7183be0-0483-4dce-8ebd-c4c6c42117e9
Hypertensive Disease - - - - - - - - - - 2 - 9 9 7 12 18 21 44. Ischaemic Heart Disease - - - - - - - - 7 1 113 26 118 70 74 119 312 216 45. Other forms of Heart Disease - - - - - - - - - - 6 1 8 11 12 24 26 36 46. Cerebrovascular Disease - - - - - - - - - 4 12 24 35 23 49 74 96 125 47. Other diseases of Circulatory System - - - - - - - - 2 - 5 3 13 9 8 22 28 34 48.
fe891253-6afa-409e-a5e0-598791138b8a
Influenza - - - - - 2 - - - 1 2 1 1 1 - 2 3 7 Carried forward 3 - 2 4 1 4 6 - 16 15 261 139 317 200 214 337 820 699 Page19. CAUSE OF DEATH AGE AT DEATH Under 1 year 1 and under 5 years 5 and under 15 years 15 and under 25 years 25 and under 45 years 45 and under 65 years 65 and under 75 years 75 years and over Total M F M F M F M F M F M F M F M F M F Brought forward 3 . 2 4 1 4 6 . 16 15 261 139 317 200 214 337 820 699 49.
5b4c7e8f-0c2e-4eb5-b536-351454eb5dab
Pneumonia 1 3 - 1 - 2 - - 1 - 10 7 23 23 44 77 79 113 50. Bronchitis and Emphysema 1 - - - - - - - - - 20 4 40 11 48 23 109 38 51. Asthma - - - - - - 1 - - - - - - . . . 1 - 52. Other diseases of Respiratory System - 2 - 1 - - - - - - 2 1 3 1 2 1 7 6 53. Peptic Ulcer - - - - - - - - - - 3 - 3 - 4 5 10 5 54. Appendicitis - - - - - - - - - - - - - . . . . . 55.
1952fcf2-e091-41a1-b5f2-9b1e8690a8d6
Intestinal Obstruction and Hernia - - - - - - - - - - - - 2 2 2 2 4 4 56. Cirrhosis of Liver - - - - - - - - - - - - 1 1 1 1 2 2 57. Other diseases of Digestive System - - - - - - - - 1 - - - 3 - 2 4 6 4 58. Nephritis and Nephrosis - - - - - - - - 1 - 4 - - 1 1 2 6 3 59. Hyperplasia of Prostate - - - - - - - - - - - - 2 ■ 1 - 3 . 60. Other diseases of genito-urinary system - - - - - - - - - 1 - 2 3 1 2 7 5 11 61.
3ed1a884-6f0c-4af1-972f-571097d3ba3f
Abortion - - - - - - - - . . . . . . . . . 62. Other complications of pregnancy, childbirth and puerperium - . . . - - - - - - - - - - - - - - 63. Diseases of skin and subcutaneous tissue - - - - - - - - - - 1 . . . _ 1 1 1 64. Diseases of musculoskeletal system and connective tissue - - - - - - - - - - 1 - 1 1 1 3 3 4 65. Congenital anomalies 4 3 1 - - 1 - - - - 1 2 . 2 . 1 6 9 66. Birth injury, difficult labour and other anoxic and hypoxic conditions 4 5 . .
98c82abe-c463-4e70-9c6c-d9bba3a6abee
- - - - - - - - - - - - 4 5 67. Other causes of perinatal mortality 5 1 - - - - - - - - - - 1 . . . 5 1 68. Symptoms and ill-defined conditions - - - - - - - - - - . . - . . 1 . 1 69. Motor vehicle accidents - - - - 1 - 4 1 3 1 3 2 - 1 3 2 15 7 70. All other accidents - - - - 1 - 2 - 2 - 4 1 4 1 2 8 15 10 71. Suicide and other self-inflicted injuries - - - - - - - - - 1 1 - 3 1 . . 4 2 72.
d46c2509-6fb4-4c3c-aae0-4457b7446ec7
All other external causes - - - - - - - - - ' - - 1 - - - 1 - Total 18 14 3 6 3 7 13 1 24 18 311 158 407 246 327 475 1106 925 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 ViceChairman 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. 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.
d6600cfb-f26c-46c0-b78e-a000226d2f09
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. One Consultant from the hospital for mentally subnormal visits the Borough and sees subnormals at the request of the Health Department. One specialist visitor (Geriatric Liaison Officer) on the staff of the Medical Officer of Health is responsible 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 on Infant Welfare Clinics there. The services of Health Visitors, District Nurses and Midwives are placed at the disposal of the family doctors as requested, the contact being made either through the Senior Nursing Staff or directly with the nursing staff concerned.
3eed6c78-2b60-4d88-b6b7-7815eb97fa14
Following the appointment of Miss Clarke as the Director of Nursing Services discussions were proceeding with the family doctors as to how to put into operation 'attachment' schemes for nursing staff in spite of the shortage of health visitors. The appointment of Miss Lambert who is the Consultant in Obstetrics and Gynaecology at Barking Hospital as Medical Supervisor of Midwives. During 1972 the scheme allowing the District Midwives to attend cases in Rush Green Hospital was commenced. Meetings between Local Health Authority Medical Officers and family doctors who carry out clinics in the area are held at which common problems and new projects are discussed. 20. HEALTH EDUCATION In January, the Health Education Section, with the rest of the Health Department, moved to Barking. The new offices are now in East Street, with the Health Education Centre at the Old Faircross School in Hulse Avenue. Once again, as far as this section was concerned, 1972 had its share of staff changes; we welcomed to the section in March, Mr.
97f7806c-22f0-49fb-9e73-8df30a1c9bde
J. Fisher to succeed Mrs. Kasim as Assistant Health Education Officer, and finances enabled us at last to fill the post of the second assistant in October, but unfortunately she was indisposed one month later and was still off sick at the end of the year. It is most pleasing to note that the demand for health education in the Borough still grows. Health Education in Schools, Colleges and Teacher's Centre The demand for "specialised health subjects" in schools has been maintained, the main topics being Human Relationships. Sexually Transmitted Diseases, Contraception, Conception and Development of the Foetus, Birth and the Addictions are included in this subject. A second Comprehensive School invited us to participate in a Family Group - Learning together - Sex Education evening for first year pupils. The response of the parents, pupils and teaching staff was overwhelming, over four hundred people attended. Thanks are due to the school staff for all their cooperation and help.
46267600-7f58-4ecd-afa6-bb4a66e3497e
The Child Care Course for the basic certificate of the National Association for Maternal and Child Welfare remains very popular and all oral examinations were carried out by staff from the Health Education section. The Health Education Officer was invited, in an advisory capacity, to attend a committee meeting held by the teachers at Westbury School, to submit a Mode 3 C.S.E. syllabus on "Family Care" to the East Anglian Examinations Board. The General Studies Department of Barking College again asked for help with the "specialised topics" of the health education programme to both day and block release students. A total of eighty-one hours has been given to this during the year. A preview for all teachers of 16 mm films on health topics, which can be borrowed free of charge from the Health Department, was held on four consecutive Monday evenings during October, at the Teacher's Centre, Westbury School.
14b16aa7-7066-4c65-a68a-3c2f71ede25c
North East London Polytechnic - Teacher's Training Course The Health Education Officer was again invited to give a lecture and demonstration on the "Use of Visual Aids in Health Teaching", to the student teachers attending the above course and one half day was given for this purpose. The attendance was good. British Red Cross Society - Public Health and Hygiene Course A course on Public Health and Hygiene was organised by the Health Education section in conjunction with the British Red Cross Society - Barking and Dagenham Division. Eight weekly two-hour lectures were given by various members of the Local Authority Health and Housing Departments. In spite of electricity cuts the course was well attended and a hundred per cent examination pass was achieved. 21. Home Safety Continued support was given to the Royal Society for the Prevention of Accidents, and a representative attended the National Home Safety Conference held at Cheltenham.
c7f11eb1-871b-4950-849d-a534c75ba54e
Many youth organisations teach home safety as part of the Service Section of the Duke of Edinburgh's Award Scheme and eighteen separate oral examinations were held in the Borough with staff from the Health Education Section acting as examiners. Displays and Exhibitions The Health Department's exhibition at the Town Show this year was produced by the Public Health Inspectorate, the theme being "Clean Food. Flies spread Disease", The staffs of both Rush Green Hospital and St. George's Hospital invited the Department to provide displays on their hospital's "Open Day", a display on "Smoking in Pregnancy" was erected at Rush Green in the foyer of the Maternity Wing and a display depicting the links between Hospital and Home for the Geriatric Patient was erected at St. George's Hospital. A further display was also provided at Barking Hospital Maternity Unit for. their "Midwives Study Day". Thanks are due to all the hospital staffs involved for their continued co-operation.
f4a04e38-bca2-407d-acac-72dd6a07cd5d
Students During the year twelve "Community Care" Students from Barking Hospital, four fourth year General Nursing Students from Rush Green Hospital and six Health Visitor Students have visited the Health Education Section. Film Preview An in-service preview of films that are kept within the Health Department was given on two consecutive days for all Local Authority Nursing Staffs. It is envisaged that this will in future be a regular occurrence. Talks to Outside Organisations Talks on a variety of health topics have been given throughout the year to various organisations such as Young Wives Groups, Y.M.C.A., Medical Section Engine Division of Fords, Royal College of Midwives and several other organisations. Films Once again film loans from the Health Department have been high, a total of 352 film bookings being made throughout the year, the majority of these were for schools and colleges, although the loans to local hospitals have more than doubled.
63fdfdba-898d-40c1-9c5f-f527fdefabf1
Due to this demand, two films have been replaced and six new films have been added to the library, including two on Family Planning, suitable for all audiences. 22. PERSONAL HEALTH SERVICES Care of Mothers and Young Children During the year 471 mothers attended our clinics for ante-natal care from the midwives. A total of 534 clinic sessions were held and in addition 1,396 attendances were made at Mothercraft and Relaxation Classes. Centres offering ante-natal care are as follows:- Centre Frequency of Sessions When held Annie Prendergast Clinic, Weekly Tuesday, p.m. Ashton Gardens, Chadwell Heath. The Clinic, Weekly Tuesday, p.m. Becontree Avenue, Dagenham. Central Clinic, Weekly Wednesday, p.m. Vicarage Drive, Barking. The Clinic, Weekly Wednesday, p.m. Ford Road, Dagenham. Marks Gate Clinic, Weekly Thursday, p.m. Lawn Farm Grove, Marks Gate.
2cd65458-b449-4ceb-a5a4-4304a3c1b206
The Clinic, Weekly Tuesday, p.m. Oxlow Lane, Dagenham. Julia Engwell Clinic, Weekly Wednesday, p.m. Woodward Road, Dagenham. Thames View Clinic, Fortnightly Monday, p.m. Bastable Avenue, Barking. 23 Child Health Centres During the year, 5,584 children attended the following centres:- Centre Frequency of Sessions When held Annie Prendergast Clinic, Weekly Wednesday and Ashton Gardens, Thursday, p.m. Chadwell Heath. The Clinic, Weekly Monday, p.m. Becontree Avenue, Wednesday, a.m. Dagenham. Central Clinic, Weekly Tuesday and Vicarage Drive, Thursday, p.m. Barking. Wednesday, a.m. The Clinic, Weekly Tuesday, a.m. Ford Road, Thursday, p.m. Dagenham. Greatfield Clinic, Weekly Tuesday, p.m. Movers Lane, Barking.
48999275-38e6-48eb-8c62-f5bb4360ab97
Julia Engwell Clinic, Weekly Tuesday and Woodward Road, Friday, p.m. Dagenham. Leys Clinic, Weekly Tuesday, p.m. Ballards Road, Thursday, a.m. Dagenham. Marks Gate Clinic, Weekly Monday, p.m. Lawn Farm Grove, Marks Gate. The Clinic, Weekly Wednesday and Oxlow Lane, Friday, p.m. Dagenham. The Clinic, Weekly Wednesday and Porters Avenue, Friday, p.m. Dagenham. Thames View Clinic, Weekly Wednesday and Bastable Avenue, Friday, p.m. Barking. 24. Welfare foods and nutrients are sold at these centres during infant welfare sessions and also at Central Clinic on Wednesday afternoons.
a2274a1e-3ab2-4e12-b4e1-4ff08d2050d2
During the year, the following amounts of welfare foods were issued:- National Dried Milk 4,761 packets Vitamin Drops 5,769 bottles Vitamin A and D tablets 692 packets Vitamin A, D and C tablets 508 packets Orange Juice 14,031 bottles PLAY THERAPY REPORT In the April of this year we started another group at Annie Prendergast Clinic. After a rather slow start we are now well established and we had 12 children attending. In the other three groups which are held at Julia Engwell Clinic, Oxlow Lane Clinic and Thames View Clinic we had 68 children attending. Some of these children had difficult home circumstances and 4 had speech difficulties. We also had 4 children attending for play therapy after being assessed at Kingsley Hall. KINGSLEY HALL ASSESSMENT CENTRE The centre continued its useful work throughout 1972. We had 35 admissions and 32 discharges with an average attendance of 12 a day.
88be9691-425f-48d2-ad5f-ded82886fe10
So it was a busy year for assessments. We had 8 staff for most of the year. We were very sorry to lose Pam Rawlings (who left to have a baby) and our faithful Mrs. Baker who has been in this building for eighteen years. We wish her a very happy retirement. The children made their usual visits to various centres sometimes accompanied by the staff as well as their mothers. These centres include the Nuffield Hearing and Speech Unit, the Wolfson Centre at the Institute for Child Health and the London Hospital Dental Clinic, and various other centres for special examinations such as Electro-encephalography or Chromosome tests. At Kingsley Hall we were lucky this year to obtain the services of an Educational Psychologist for one session a week to help us assess the children, particularly those with communication difficulties. In addition we had for two full days each week the help of Mrs. Warwick our Physiotherapist without whom we would find it very difficult to manage. 25.
e8c2692a-7706-434e-bb04-abe48efcb417
Apart from dealing with the children in Kingsley Hall our Physiotherapist sees seven or eight children who come in from all parts of Barking. During this year we were visited weekly for about four months by Dr. Peter Rosenbaum who came from Toronto on a Fellowship to Great Ormond Street Hospital and was writing a thesis on the facilities for physically handicapped children who were attending Kingsley Hall. He also interviewed the staff, the health visitors, the social workers etc. This thesis was written in conjunction with investigation at the Physiotherapy Department at Great Ormond Street. His general conclusion was that both children and parents benefited from a small centre in their own neighbourhood where they could spend the whole day as they can at Kingsley Hall more than at a large highly organised centre to which they might have to travel long distances. We have had frequent periodic visits from staff and students at the Wolfson Centre throughout the year both to give us help and to see something of our management of these children.
8f1be5a2-f0ff-46fc-8804-adfbbf6e5d1f
We were very honoured when the local Consultant Paediatrician, Dr. Nauth-Misir, came to see us. He seemed very impressed with the facilities available and the work done at Kingsley Hall. He has used it quite a lot over many years for his handicapped patients but this was his first visit and we hope he will come again often.
53b6dbd1-1796-4803-9ac0-521ab687b798
KINGSLEY HALL - STATISTICS 1972 Jan Feb Mar Apl May Jun Jul Aug Sep Oct Nov Dec Children on Register 18 20 20 18 21 20 22 19 19 19 20 19 Children Admitted 4 5 4 1 5 4 2 1 4 3 2 - Children Discharged 2 3 4 3 2 5 - 4 4 3 1 1 Average Daily Attendances 11 11 12 14 13 14 14 12 13 14 12 8 Children Escorted for Treatment - - 2 4 10 4 1 - 3 1 5 2 Journeys Made - - 1 3 7 3 3 - 2 1 4 2 Children seen for Assessment 6 6 2 2 3 4 2 - 7 4 1 - 26.
1876611a-e180-4eef-a0b7-345685f0d897
COMMUNITY NURSING SERVICE This was an eventful year for the Community Nursing Service. The Mayston Management Structure was implemented. Miss E.M. Clarke was appointed as Director of Nursing Services and took up her appointment in April. Miss Dobson was already in post when Miss P. Broadbent commenced duties as Area Nursing Officer in September. Other appointments included five Nursing Officers, vizi- Mrs. Clegg & Mrs. Ward with Special Responsibilities for Health Visitors Miss Smith & Mr. Turpin with Special Responsibilities for District Nurses Miss Teather with Special Responsibilities for Midwives I am happy to report again this year that a full complement of District Nurses and Midwives was maintained. Eight of the ten Midwives are recognised "Teaching Midwives", undertaking, as well as their midwifery duties, the added responsibility of instructing Pupil Midwives from Barking Hospital in Community Midwifery Practice and Care. Altogether 13 pupil midwives received this training.
0ea0da19-0d43-40ac-919d-f8f5b3236fa8
The Midwives have also participated in Mothercraft Instruction to ante-natal mothers. Three Midwives attended Statutory Refresher Courses. The high standard of nursing care was maintained by the District Nurses. Due to the promotion of Mr. Turpin there remained only two male nurses working in the field. Although recruitment for female nurses is good, we failed to recruit a suitable male nurse. One District Nurse attended a Refresher Course. Two District Nurses received District Nurse Training. Health Visitors recruitment continues to present concern, not only locally, but nationally. Nevertheless, the Health Visitors in post with heavy caseloads have, with support from Ancillary Staff, maintained an excellent service, which is commendable. The Health Visitors held regular Parent Craft Classes in eight of the local authority clinics. Three of the Health Visitors are also Field Work Instructors, each participating in Student Health Visitor Training, in conjunction with the North-East London Polytechnic. Five Health Visitors attended refresher courses during the current year.
d3e637f6-68d3-45ca-a5bf-4fb67d4e19c3
The two sponsored Health Visitor Students completed their training and were successful in passing their examination. All three branches of the nursing service personnel have, as well as carrying out their normal duties, given instruction to other disciplines, such as Trained Nurses and Student Nurses from neighbouring hospitals, Social Service Staff and their students, taking them on their days' rounds as observers. This was a valuable service and was much appreciated. All staff should be commended for their work during the year. 27. Student Health Visitors As in previous years the Borough sponsored two students for training as Health Visitors. STATISTICS Midwifery Service Number of domiciliary confinements attended by midwives 177 Number of hospital confinements attended by domiciliary midwives 27 Cases delivered in hospitals and attended by domiciliary midwives on discharge within: 2 days 258 3 - 7 days 700 8 or more days 892 Home Nursing Service Total number of persons nursed during the year 2,
8df430e5-e45b-4ca6-ae9e-cb74da182b83
207 Number of persons who were aged under 5 at first visit 14 Number of persons who were aged 65 or over at first visit 1,436 Health Visiting Service Cases Visited by Health Visitors Number of Cases Children born in 1972 2,578 Other children under 5 4,640 7,218 Persons aged between 5 and 16 seen as part of health visiting 179 Persons aged between 17 and 64 2,109 Persons aged 65 or over 360 Number of tuberculous households visited 122 Number of households visited on account of other infectious diseases 65 Persons included above who are:- Mentally handicapped 48 Mentally ill . 30 28. SOCIAL SERVICES DEPARTMENT Medical Reports on all children boarded out into foster homes during the year were perused by the Deputy Medical Officer of Health who brings to the notice of the Director of Social Services any important medical aspects that require observation or treatment.
b6bb3193-cd5e-44e3-b3f7-3bd883f2d1e9
A Medical Officer continued to attend at the Adult Training Centre for one session per week for Medical Inspection of Trainees. The Council's Day Nurseries were also regularly attended by Medical Officers who monitor development and advise on the health of the children. VACCINATION AND IMMUNISATION The following statistics relate to persons protected at Council Clinics or by General Practitioners during 1972:- VACCINATION AGAINST MEASLES 1972 Year of Birth Primary Vaccination 1972 1 1971 760 1970 642 1969 63 1965 - 68 161 Others under age 16 6 Total all ages 1,633 MEASLES NOTIFICATIONS - 1967 - 1972 1967 1,630 1968 175 1969 207 1970 304 1971 234 1972 109 29.
dfc629d4-0d2f-4ecb-acc9-4e0134937984
WHOOPING COUGH IMMUNISATION Year of Birth Primary Immunisation Children who received a booster dose 1972 8 _ 1971 1,321 13 1970 362 17 1969 48 14 1965-68 26 155 Others under age 16 - 24 Total all ages 1,765 223 DIPHTHERIA IMMUNISATION Year of Birth Primary Immunisation Children who received a booster dose 1972 8 . 1971 1,328 15 1970 364 21 1969 50 37 1965-68 181 1,949 Others under age 16 37 180 Total all ages 1,968 2,202 30.
130898cb-ed54-4cb9-ad22-dd2681c212cd
TETANUS IMMUNISATION Year of Birth Primary Immunisation Children who received a booster dose 1972 8 _ 1971 1,328 15 1970 364 25 1969 51 38 1965-68 189 1,991 Others under age 16 359 1,024 Total all ages 2,299 3,093 POLIOMYELITIS VACCINATION Year of Birth Primary Vaccination Children who received a booster dose 1972 8 - 1971 1,359 9 1970 353 25 1969 51 38 1965-68 185 1,995 Others under age 16 63 1,903 Total all ages 2,019 3,970 B.C.G. VACCINATION B.C.G. vaccination is a safe and very effective method of protecting the individual against tuberculosis.
d3c9f928-5d71-4e45-a0ac-8d359cf4b3cb
Extensive trials in England and Wales have shown that it provides 80% protection against subsequent tuberculous infection. The protection is long lasting and remains substantial for 10 or more years after vaccination. During 1972, 964 children were given B.C.G. vaccine, a decrease of 401 over 1971. 79 pupils had a Grade 2 or more reaction to Heaf testing and were referred to the Consultant Chest Physician for further investigation. It is now our policy to vaccinate children showing Grade 1 response to Heaf testing as it is more than probable that their response to the Heaf test is due to mycobacteria other than tuberculosis. In addition 194 contacts of tuberculosis were vaccinated by the Chest Physician, and 34 babies were vaccinated at birth. RUBELLA VACCINATION Number of girls vaccinated between their 11th and 14th birthday - 1,844.
82396979-8c40-4461-8773-4f66c5f4bba0
This programme of immunisation of girls should, in the years ahead, lead to a declining incidence of children handicapped by the rubella syndrome which includes defects of hearing and vision and also defects of the heart. 31. FAMILY PLANNING SERVICE In October 1972 the Borough Council agreed to provide the family planning service free and it is hoped that this may continue after April 1974,when following reorganisation of the National Health Service the Area Health Authority is due to take over this service from the Council:- The following sessions are now held in the Borough:- Annie Prendergast Clinic - Wednesday, 6.30 p.m. - 8.00 p.m. Barking Hospital - 1st and 3rd Thursday in the month - Afternoon Central Clinic - Monday, 7.00 p.m. - 8.30 p.m. Five Elms Clinic, - Tuesday, 7.00 p.m. - 8.30 p.m.
5ec4271e-1f8f-43a0-8f13-0babb8d95bea
Five Elms Road Ford Road Clinic - Monday, 7.00 p.m. - 8.30 p.m. Thames View Clinic - 2nd and 4th Thursday in the month - 7.00 p.m. - 8.30 p.m. In addition the domiciliary family planning service continued, for those special cases where more intensive care is required. REPORT OF THE GERIATRIC LIAISON OFFICER The Geriatric Liaison Officer continued to pay home visits to advise on the care of the elderly. Cases visited 1972 No. of Cases Referred by Geriatric Consultants on discharge from hospital 196 Referred by General Practitioners 11 Referred by Consultant Physicians on discharge from hospital 121 Miscellaneous Referrals 287 Revisits to cases 664 1,279 32.
a0973601-2663-47a4-a0c3-89dfce84636b
GERIATRIC CLINIC Our Geriatric Clinic has gained much favour in the past and it was a pity that for the reasons of staff difficulties we could not manage more than two courses during the year. We had 23 patients attending and the attendance was very good. Of these 16 asked for medical examination but there was one gentleman who was under investigation in two hospitals concurrently so he was not examined. The ages of the remaining 15 ranged from 63 to 79 plus a lady aged 52. Attendance at family doctors' surgeries One had not seen her family doctor for more than a year and had hypertension with symptoms. Two had not seen their family doctors for 6 months and one of these had glycosuria, and was very obese (28%).
63986144-41f6-4d1b-9779-f215d8bda18d
Marital state of those examined F. M. Married and living with spouse 5 2 Widow or widower living alone 4 2 Widow or widower living with relations - 1 Single person living alone - 1 Obesity Grossly Obese Moderate Underweight Normal 6 1 3 5 Hypertension Seven people were found to suffer from hypertension. One was reasonably controlled by treatment while six did not know about the condition. Two had symptoms, one having arrhythmia and another headaches and palpitations but had not seen her family doctor about these symptoms. Other cardiac conditions - One heart block. Deafness One very deaf lady aged 63 was referred to the Otologist and one very deaf gentleman of 77 was using a hearing aid. Seven who were moderately deaf were able to cope fairly well with their disability. Eye Conditions All those who attended were in need of glasses, one for reading only.
ac6221a3-36d0-4b42-86a7-b72087f5832b
One 71 year old lady was attending Moorfields for investigation and one lady of 69 suffering from diabetes wa. also under investigation, while one lady aged 63 had cataract. 33. Miscellany One man was under the care of the London Hospital for bronchitis and one 70 year old man had a recurrence of bilateral hernia. The 52 year old female had uterine fibroids and suffered from anxiety state, while another aged 63 suffered from epilepsy for which she was already receiving treatment. It seems that this sort of clinic does play a useful part. At the end of each course we ask for comment and criticism and it is rewarding that each time they find the course interesting and helpful. The course is designed to teach the Over 60's and to encourage them to talk to the staff and doctor; it helps to resolve whatever problems they may have.
4e959bbf-127e-4a01-88a0-ed983f0e6052
People do not like to take up the time of the family doctor who they think is very busy and they are grateful for the time we spend with them. They can talk and reveal their anxieties and occasionally we also discover a condition they did not feel was serious enough to trouble their doctor with. There is always the probability that the withdrawn or the more seriously ill will not come to these courses, but the doctor would know about the seriously ill and one hopes that the Health Visitor or Social Worker would know about the withdrawn. One also hopes that working within the community, one gets to know the people and very likely they will draw ones attention to such cases and give the possibility to contact them. 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.
9b415bf8-7d9e-4aba-98db-58f53123a2ae
2,018 articles were loaned during the year and 3,895 items were out on loan at the year's end. In addition, non-returnable items for incontinent patients were supplied in considerable quantity. 38,400 disposable incontinent pads were issued and 120 patients were supplied with waterproof pants or knickers with disposable linings. Thirty Ripple Beds were also loaned through hiring arrangements with manufacturers; this being the most economical way of obtaining these items in view of their high cost and maintenance charges. 34. MEDICAL EXAMINATION OF STAFF The medical invagination of new entrants to the Council's service, and the review of cases absent from duty owing to illness continued during the year. Generally the physical condition of candidates for appointment is satisfactory. During the year 964 health questionnaires were submitted for scrutiny. 728 candidates were approved without further enquiry and 10 were accepted after satisfactory reports had been received from general practitioners or hospital consultants. The following examinations were carried out:- No.
d63daec9-ec72-42b3-bc2d-336f0cf57f95
of persons medically examined 166 No. of persons found to be unfit 3 No. of persons accepted conditionally 37 No. of persons examined in connection with sickness payments 27 No. of persons examined for other authorities 2 No. of persons examined by other authorities 13 No. of Chest x-rays arranged in connection with medical examinations ... 375 ADAPTATIONS OF HOMES TO INSTALL ARTIFICIAL KIDNEY MACHINES Patients suffering from chronic renal failure who are suitable for treatment at home may have their homes adapted by the local authority to enable the necessary equipment to be installed and operated in hygienic conditions. During the year two homes were adapted and in one case adapted earlier the patient had a successful kidney transplant. During 1972 also it was found that in one case for which adaptation had been made the patient was unable to carry out home dialysis.
73c7cf3c-a43b-42cb-89bd-4fb725017cc1
By arrangement with Redbridge Borough Council the patient was rehoused and a Redbridge patient who could carry out his own dialysis was transferred into the adapted house. 35. REHOUSING ON MEDICAL GROUNDS As in previous years my Department has contiued to act as adviser to the Housing Department where applicants have put forward medical grounds in their claims for rehousing. As almost half the cases require a visit from at least one and sometimes two or more members of staff as well as enquiries to hospital or family doctor, it will be seen from the statistics given below that this often difficult task continues to require a considerable amount of time from the staff of the Health Department. Statistics Total number of applications 502 Number of recommended for rehousing 179 NATIONAL ASSISTANCE ACT, 1948 - SECTION 47. During the 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.
34bc0a23-e280-4b31-9d37-d883ab8ada2f
CYTOLOGY SERVICE 1972 Total number of patients seen was 1,551 of which 331 were residing out of the Borough. This was 100 more than in 1971. We have continued our campaign in trying to reach a wider circle of women and have contacted several larger factories. The response was good and invariably the women showed great enthusiasm and were most appreciative. This accounts for the large number of women residing out of the Borough. We had four positive and four suspect smears. Table 1 shows the positive smears. 36. Table 1. Age Social Class Para Cytology Report Treatment 1. 39 3 1 Numerous greatly atypical cells highly suggestive of malignancy. Cone biopsy - Hysterectomy 2. 47 3 1 An infected smear showing several atypical cells ? ca in situ. Cone biopsy - Hysterectomy 3.