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Sabin 2 298 1062 168 2402 1728 5660 10. Measles β€” β€” - β€” β€” β€” β€” 11. Total immunised against Diphtheria (Lines 1-2-3-4-5) 1 302 1044 134 2248 390 4119 12. Total immunised against Whooping Cough/Pertussis (Lines 1-2-3-6) 1 256 888 88 651 70 1954 13. Total immunised against Tetanus (Lines 1-2-4-7) 1 303 1048 145 2286 1411 5194 14. Total immuhised against Polio (Lines 1-8-9) 2 298 1062 168 2402 1728 5660 B.C.G.
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Vaccination against Tuberculosis School children and students were vaccinated at school and at establishments for further Education by the Department's medical staff and contacts of tuberculosis were vaccinated at Chest Clinics in the Borough. A tuberculin test was offered to young immigrants arriving in the Borough during the year and, where the result was positive, arrangements were made for further investigation and supervision at a chest clinic. Tuberculin Test and B.C.G. Vaccination No. of persons vaccinated through the Authority's approved arrangements under Section 28 of the National Health Service Act. (a) CONTACTS (i) No. skin tested 175 (ii) No. found positive 28 (iii) No. found negative 147 (iv) No. vaccinated 131 106 (b) SCHOOL CHILDREN AND STUDENTS (excluding those known to have had B.C.G. vaccination already) (i) No. skin tested 4,125 (ii) No.
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found positive 366 (iii) No. found negative 3,461 (iv) No. vaccinated 3,428 (c) SCHOOL CHILDREN AND STUDENTS (known to have previously had B.C.G. vaccination) (i) No. skin tested 188 (ii) No. found positive 145 (iii) No. found negative 33 (iv) No. vaccinated 30 Whooping Cough Vaccination The Authority continued to co-operate in the investigation by the Public Health Laboratory Service of the sero-types currently responsible for cases of whooping cough. Smallpox Vaccination There were no reports of cases of generalised vaccinia or post-vaccinal encephalomyelitis or death from any other complications of vaccination.
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107 Smallpox Vaccination Persons aged under 16 Age at date of Vaccination Number of persons vaccinated or re-vaccinated Number Vaccinated Number Re-Vaccinated 0 β€” 3 months 6 β€” 3 β€” 6 months 26 β€” 6 β€” 9 months 17 β€” 9 β€”12 months 12 β€” 1 year 844 13 2β€”4 years 435 89 5 β€”15 years 187 166 TOTALS 1527 268 CLINIC PREMISES Main Clinics Clinic Sessions (See Key Table on page 109) Brunswick Park Road,N.11. I.W.C. C D SP DV OPH ORT T Town Hall, Hendon, N.W.4. I.W.C. CSC D OPH ORT SP CHIR DV A/N A/NE-M/C Garth Road, N.W.2. I.W.C.
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C D SP CHIR DV A/N A/NE-M/C CSC 149 East Barnet Road, I.W.C. CSC C D SP Barnet DV A/NE-M/C A/N(M) Holly Park, N.ll. I.W.C. D SP CHIR DV A/N CSC Hartley Avenue, N.W.7. I.W.C. CSC D SP CHIR DV A/N A/NE-M/C M/C Oak Lane, N.2. I.W.C. C D SP CHIR DV A/N A/NE-M/C OPH ORT CSC T Oakleigh Road, N.20 I.W.C. DV A/N A/NE-M/C CSC T Sutton Road, N. 10 I.W.C. SP DV A/N A/NE-M/C CSC T Torrington Park, N.12 I.W.C. C CSC SP CHIR A/N A/NE-M/C Vale Drive, Barnet I.W.C.
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CSC SIC C D v SP DV A/NE-M/C OPH ORT A/N(M) 36 Cressingham Road, I.W.C. CSC C D SP Burnt Oak CHIR A/NE-M/C OPH ORT CE York Road, N.W.9. I.W.C. CSC C D SP CHIR A/N A/NE-M/C CE Claremont Way, N.W.2. I.W.C. Approach Road, Edgware I.W.C. CSC SP CHIR A/N A/NE-M/C Other Premises Etchingham Park Road,N.3. I.W.C. CHIR St. Andrew's Church Hall, I.W.C. DV Lynford Gardens. Edgware. 108 Other Premises (continued) St. Stephens Hall I.W.C. Bells Hill, Barnet Dollisfield, Totteridge I.W.C. Lane, N.20.
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United Free Church Hall, I.W.C. Sanders Lane, N.W.7. St. Barnabas' Church Hall I.W.C. DV Cranbourne Gardens, N.W.ll. St. Mark's Hall I.W.C. Woodville Road, Barnet Congregational Church Hall I.W.C. Colin Close, N.W.9. St. Mary Magdalene Church I.W.C. Hall, Holders Hill Road,N.W.4. KEY TABLE I.W.C. Infant Welfare Clinic CSC Consultative School Clinic A/N Ante-Natal Clinic CE Clinic for Elderly OPH. Ophthalmic SP Speech Therapy M/C Mothercraft only A/NE-M/C Combined Ante-Natal Exercises and Mothercraft ORT Orthoptic A/N(M) Ante-Natal Clinic β€” Midwife only D Dental CHIR Chiropody DV Development Clinic T Toddlers Clinic C Cervical Cytology S.I.C. Special Investigation Clinic.
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109 SCHOOL HEALTH SERVICE SCHOOL HEALTH SERVICE Introduction The regular medical inspection of children in attendance at Local Authority Schools continued, any necessary treatment being obtained either at Clinics or through facilities provided under the National Health Services Act, 1946. The School Health Service continued to foster co-operation between Departments of the Authority and outside agencies in regard to handicapped children, and as a further step in this direction, I have arranged that a handicapped child before leaving school shall be discussed at a case conference, to assess the child's ability and advise the welfare agencies and Youth Employment Service of the future needs of these young people. In accordance with the requirements of the Education Act, 1944, 91 children were reported to the Authority during the year as suffering from a disability requiring some form of special educational treatment. School Population The overall increase in the school population for the Borough continued during the year, and the following table shows the position at 31st December, 1969:- Schools No.
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of Pupils Primary Schools 24,449 Secondary Modern and Bilateral Schools 10,816 Grammar Schools 7,882 1 Residential Special School (E.S.N.) 178 2 Day Special Schools (E.S.N.) 259 43,584 Periodic Medical Inspections The Authority continued the policy of routine medical inspection of school entrants and leavers together with an intermediate examination during the last year at the primary school. In addition a close contact was maintained between the School Medical Officers and Head Teachers. 113 The following table shows the number of children inspected by years of birth and the state of their physical condition - Year of Birth Number of Pupils Inspected Physical Condition of Pupils Inspected Satisfactory Unsatisfactory 1965 8s later 260 260 1964 1,999 1,997 2 1963 1,585 1,
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584 1 1962 358 357 1 1961 301 300 1 1960 254 254 _ 1959 873 872 1 1958 1,729 1,728 1 1957 646 644 2 1956 326 326 β€” 1955 2,350 2,350 β€” 1954 & earlier 1,263 1,261 2 TOTAL 11,944 11,933 11 Percentage of pupils inspected whose physical conditions was found:- Satisfactory 99.91% Unsatisfactory 0.09% Medical Treatment In the tables of statistics which follow this section of the report, details are given of treatment (excluding uncleanliness and dental disease) of pupils attending maintained primary and secondary schools (including nursery and special schools), whether provided directly by the Council or arranged for through other agencies.
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Ophthalmic Clinics The five school ophthalmic clinics continued to operate at centres dispersed throughout the Borough, with ophthalmologists provided by the North West Metropolitan Regional Hospital Board and at Central Hendon Clinic and Vale Drive Clinic an orthoptic service is provided. Audiometry Two Audiometer Operators carry out three routine hearing tests during the school life of those children in the Borough attending the Authority's schools and also test, as special cases, those children suspected of having a hearing loss 114 The following Table shows the number of pupils whose hearing was tested:- Sweep tests 10,564 Re-tests 654 Special tests 939 Re-tests 268 Audiology Those children requiring further investigation for a loss of hearing are referred to the Consultant Otologist at one of the audiology units established in the London Borough of Haringey and the London Borough of Brent. Peripatetic Teachers for the Deaf attached to these units visit those children in schools in this Borough who are in the care of the units and require supervision or training.
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It has still not been possible to appoint a Peripatetic Teacher for the Deaf to care locally for those other children who are attending Consultants at the various London Hospitals. During the year 23 school children and one child under school age were provided with hearing aids and at the end of the year 88 school children and 5 children under school age (4 of whom were attending the Local Authority Day Nurseries) were known to have hearing aids. Child Guidance Service Under the joint administrative responsibility of the Chief Education Officer and myself the Local Authority Child Guidance Service operates from centres at:- 304, Regents Park Road, Finchley, N.3. and The Health Clinic, Vale Drive, Barnet, Herts. Dr. A.D. Black, Consultant Child Psychiatrist and Medical Director reports:- "Until September, 1968, this Borough was without a Child Guidance Centre.
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A School Psychological Service had been in existence for some years, but in September, 1968, a Child and Family Psychiatric Service was initiated at Finchley with a Professional Staff consisting of:- 115 1. A part-time Consultant Psychiatrist and Medical Director (3 sessions per week) 2. Three full-time Psychiatric Social Workers 3. One full-time Psychotherapist and able to make use of the Consultant Services of 4. Three full-time Educational Psychologists who were jointly appointed to the Psychiatric Service and School Psychological Service. A second Clinic is opening at Vale Drive Health Clinic in June, 1970. Since our psychiatric resources have been very limited we decided to concentrate our work on consultative services. We have held regular meetings with School Medical Officers, Health Visitors, Speech Therapists, Education Welfare Officers, Supervisors of Pre-School Play Groups and other community workers. Clinical work has, however, taken up the majority of our time.
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In the year ending 31st August, 1969, 369 children and their families were referred to the Clinic, of these we accepted 322 and were able to suggest to the referrer ways of seeking help for the others whom we were unable to accept. In some cases we contacted other psychiatric Clinics, who agreed to see children whom we were unable to see. We have also been able to offer a limited service to the Courts who have asked us to see children for psychiatric assessment and court reports. Origin Total Referral Agency No. (Assistant Medical Officer 86 ( (Educational Welfare Officers 14 School Services 178 ( (Educational Psychologists 51 ( (Schools 27 (General Practitioners 37 Other Medical Services 80 ( (Other Clinic and Hospitals 43 (Probation Officers 11 Other Social Services 18 ( (Child Care Officers 7 Direct 46 Parents 86 Adolescents 46 TOTAL 322 TOTAL 322 116 This table shows the main sources of our referrals.
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It will be seen that the majority of our referrals come from the School Health Service and the School Psychological Service, either directly or indirectly. Other medical referrals form the next largest group, as many coming from other Hospitals and Clinics as have come from General Prattitioners. In line with most other Child Guidance Clinics and the Underwood Committee recommendations, we accept direct referrals from parents although we in all cases request permission to contact the General Practitioners. This is rarely refused. Diagnostic Categories The largest number are classified as anti-social conduct disorders, neurotic illnesses and the primary behaviour disorders of childhood. There is a small but significant number of children with depressive illnesses, with psychotic illnesses of the schizophrenic type and autism. We have seen a small number of children with psychosomatic illnesses and we are increasingly recognising children with brain damage and brain dysfunction. Much emotional and behavioural disturbance in childhood is however multi-factorial in origin.
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Treatment Drug Therapies We make use of drug therapies to alter mood and aggressive behaviour in particular, to sedate and tranquillise anxious and hyper-active children; in the treatment of nocturnal enuresis, and in psychosis. Environmental Manipulation Environmental manipulation involving casework with parents and counselling of teachers; placement in a special environment. Psychotherapy Various forms of psychotherapy are the mainstay of our therapeutic armamentarium but our psychotherapeutic sources are extremely limited. All the professional staff at the Clinic are involved in psychotherapeutic work with children, parents and whole family groups. We recognise however that even if our staff were to be doubled in size we would not be able to meet the therapeutic needs of the community and in common with other Child Guidance Clincs are exploring newer methods of treatment and prevention.
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Crisis Consultation We are particularly interested in developing a Crisis Consultation Service as we feel there is a real opportunity to help families at the point of crisis and thus possibly prevent some of the pathological long term effects known to ensue from inadequately worked-through situations of overwhelming grief, or anxiety, such as in bereavement or traumatic events. We give priority to young children referred to us, to children with school refusal and children with behaviour disorders following the death of a parent, in order to try to offer crisis therapy where appropriate. 117 The setting up of the Child Guidance Centre has revealed the necessity in this Borough for a service for handicapped children, in particular children who are maladjusted, or who have multiple handicaps. There is a great need for day and boarding placement for severely maladjusted children within the Borough. There is a need of a wide range of both medical and non-medical placements for children coming to the Clinic.
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Many multi-problem families are referred to us whose needs could much more adequately be met by a Family Service Unit if one existed in the Borough. % Conclusion Comparing the figures of children referred to our psychiatric services in the Borough with those at other boroughs, with longer established child guidance clinics it is clear that an unsatisfied demand for psychiatric services exists in the Borough. I think it is unlikely that our high referral rate is an artefact due to the fact that we are getting children referred who have been waiting some years for help, nor can we hope that the numbers referred will drop off significantly. What is more important, the number of children referred with acute disturbances is increasing, and these are the children who may be helped most economically with short term or family group therapy. Even if the staffing establishment in Child Guidance Centres within the Borough is increased, it is unlikely that the needs of disturbed children within the Borough will be adequately met from these Centres alone.
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The staff of Child Guidance Centres must spend time increasingly therefore in working with people in the community who are involved with children, particularly parents, teachers, doctors, nurses and social workers, in order to help raise the level of therapeutic skills and also increase the Borough's range of preventive services, in the hope this will lessen the number of children who need help." Speech Therapy There are five whole-time speech therapists employed by the Authority who undertake sessions within the School Health Service at clinics and in the Day Special Schools and Junior Training Schools in the Borough. The diagnosis and treatment of speech and language disorders is the responsibility of the speech therapists who give advice to parents and teachers so that treatment can be continued outside the ilinic sessions. During the year a total of 618 children received treatment and supervision. National Child Development Study There has been a second follow-up of children born in the week 3rd to 9th March, 1958.
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The survey is intended to gather information about the educational progress, health, physical development and home background of these children and, for this purpose 56 children in the Borough were examined by Medical Officers and parental 118 interview forms were completed by the Nursing Staff. The results of these investigations have been sent to the Study's Senior Research Officer for analysis. Handicapped Pupils The various categories of handicapped pupils are defined by The School Health Service and Handicapped Pupils Regulations, 1959, as follows:- Blind Epileptic Partially Sighted Maladjusted Deaf Physically Handicapped Partially Hearing Delicate Educationally Subnormal Children suffering from Speech Defects Section 34 of the Education Act, 1944, makes it a duty of the Local Education Authority to ascertain what children in the area require special educational treatment and to provide such treatment either in special school or, otherwise, by special methods appropriate to the handicap of the particular child. The Authority maintains three special schools for handicapped children.
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Oak Lodge Day Special School for Educationally Subnormal Pupils, Oak Lane, East Finchley, N.2. Northway Day Special School for Educationally Subnormal Pupils, The Fairway, Mill Hill, N.W.7. Swaylands Residential Special School for Educationally Subnormal Boys, Penshurst, Tonbridge, Kent. Children with handicaps in other categories are found placement by the Chief Education Officer in special schools maintained by other authorities or independent bodies. Future provisions for special education in the Borough, as outlined in the Education Development Plan, includes two Day Special Schools for Maladjusted Children and a Day Special School for Delicate/Physically Handicapped Children. Also envisaged in the plan is the provision of a Residential Special School for Maladjusted Boys by means of future extensions to Swaylands School.
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There appears to be a general shortage of Special School places in England and Wales and the latest report of the Chief Medical Officer of the Department of Education and Science shows that for every 6-7 children in Day Special Schools and every 2-3 children in Residential Special Schools there is one child still requiring to be placed in that type ot school I am concerned that this Authority is now experiencing difficulty in obtaining Da> Spec ial School placements for handicapped children, 119 particularly the deaf, partially hearing and physically handicapped requiring special educational treatment. There are also children in ordinary schools who would benefit from the less rigorous regime and medically beneficial atmosphere of a Day Special School for Delicate Children, but the long journey, twice daily, to the nearest school of this kind makes such a recommendation pointless.
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When leaving school handicapped children, having been educated either in Special School or having had some other special educational treatment, have greater problems regarding future employment and social adjustment than other school children, and it becomes apparent that the majority of them require the continual help of the welfare services of the Authority into adult life. In finding suitable work for them the Youth Employment Service should have as much information on their ability as is known to the various Departments of the Authority. Case conferences have therefore been arranged so that the needs of handicapped school leavers can be considered by a panel consisting of the Principal Medical Officer for Mental Health, the Principal Welfare Officer, the Principal Youth Employment Officer and the Borough Childrens Officer or their representatives, together with appropriate Officers nominated by them and the Chief Education Officer. The Principal Medical Officer for Child Health is the Co-ordinating Chairman of the panel, supplying them with all relevant reports and information and recording their decisions, so that when these children leave school consistent advice and continuing support is available.
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The following Table shows the number of handicapped pupils as at 31st December, 1969. Special Day Schools Special Residential Schools Maintained Primary & Secondary Schools Independent Schools Not at School Total B G B G B G B G B G B G Blind 2 4 1 4 3 Partially Sighted 5 4 1 1 - 1 - 1 - - 6 7 Deaf 3 3 2 4 1 - - - 3 1 9 8 Partially Hearing 11 7 2 - 3 2 - 1 1 1 17 11 Delicate 8 1 8 5 - 1 1 - 1 - 18 7 Educationally Subnormal 91 76 23 6 1 1 1 ,
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1 _ 117 83 Epileptic - - 2 - 1 - - - - - 3 - Maladjusted 1 3 44 12 12 3 6 1 1 - 64 19 Physically Handicapped 22 11 10 6 3 1 1 - 2 3 38 21 Speech Defects - - - 1 1 1 β€” β€” β€” β€” 1 2 Total No. Handicapped Pupils 141 107 96 36 22 10 9 3 9 5 277 161 120 Special Transport to School Section 55 of the Education Act, 1944, provides for the provision of transport to facilitate the attendance of pupils at school and, during the year, special transport was recommended on medical grounds for 24 children attending ordinary schools. The length of time for which the transport was required varied according to the needs of the individual cases.
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Home Tuiton During the year 20 children were recommended home tuiton, under Section 56 of the Education Act, 1944, for varying periods in accordance with their disability. SCHOOL HEALTH SERVICE STATISTICAL TABLES PUPILS FOUND TO REQUIRE TREATMENT AT MEDICAL INSPECTION (excluding dental disease and infestation with vermin) Year of Birth For defective vision (excl.
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squint) For any of the other conditions recorded Total Individual Pupils 1965 & later 5 6 11 1964 53 114 156 1963 56 160 191 1962 20 25 44 1961 13 13 24 1960 13 11 20 1959 46 90 129 1958 145 141 239 1957 58 40 90 1956 28 17 46 1955 295 134 391 1954 & earlier 172 62 218 TOTAL 904 813 1,559 121 PERIODIC INSPECTIONS Defect Code No. Defect or Disease Entrants Leavers Total incl. all others age groups Special Inspections 4 Skin T O T O T O T O 28 61 27 38 85 153 3 - 5 Eyes. a) Vision 129 371 428 188 904 820
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79 93 b) Squint 39 19 14 20 74 59 8 _ c) Other 3 7 4 3 7 23 3 2 6 Ears a) Hearing 44 142 14 22 85 221 12 46 b) Otitis Media 12 49 3 4 21 66 1 8 c) Other 7 7 1 - 11 12 1 - 7 Nose & Throat 30 129 6 28 48 208 6 10 8 Speech 35 67 4 4 58 85 17 5 9 Lymphatic Glands 1 27 - 5 2 35 - I 10 Heart 5 42 1 18 8 84 2 2 11 Lungs 8 61 7 8 27 118 3 4 12 Developmenta 1: a) Hernia
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4 17 2 5 14 35 3 2 b) Other 2 86 5 4 28 119 3 7 13 Orthopaedic: a) Posture 1 22 13 29 58 84 β€” 1 b) Feet 17 62 24 31 75 137 3 6 c) Other 8 23 4 11 23 47 - 1 14 Nervous System a) Epilepsy 3 18 1 6 10 33 2 1 b) Other - 10 3 2 3 22 - - 15 Ps ychological a) Development 2 22 1 6 7 52 4 2 b) Stability 1 72 1 22 9 151 12 16 16 Abdomen 1 14 7 7 8 31 - - 17 Other 59 178 28 42
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161 275 23 25 T β€” requiring Treatment O β€” requir'ng Observation 122 TREATMENT OF PUPILS ATTENDING MAINTAINED PRIMARY AND SECONDARY SCHOOLS (including Nursery and Special Schools) GROUP 1: No. of cases known to have been treated Eye Diseases (e.g. blepharitis, conjunctivitis). Defective Vision and Squint (a) External & other, excluding errors of refraction & squint 9 (b) Errors of refraction, including squint 2,095 TOTAL: 2,104 (c) No. of pupils for whom spectacles were prescribed 703 GROUP 2: Diseases and Defects of Ear, Nose and Throat Received operative treatment for: (a) Diseases of the ear - (b) Adenoids and Chronic Tonsilitis 54 (c) Other nose and throat conditions - Received other forms of treatment - TOTAL: 54 Total No.
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of pupils in schools who are known to have been provided with hearing aids: (a) in 1969 23 (b) in previous years 65 GROUP 3: Orthopaedic & Postural Defects No. of pupils known to have been treated in clinics or at out-patients departments - GROUP 4: Diseases of the skin (excluding uncleanliness) Ringworm (i) scalp 3 (ii) body 3 Scabies 17 Impetigo 12 Other skin diseases β€” TOTAL: 35 GROUP 5: Child Guidance Treatment No. of pupils treated at Child Guidance Clinics 304 GROUP 6 Speech Therapy No. of pupils treated by speech therapists 618 GROUP 7: Other Treatment given: (excl. B.C.G.
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vaccination) (a) Minor ailments 27 (b) Convalescent treatment under School Health Service arrangements 33 TOTAL: 60 Education Act 1944 β€” Section 57 Cases dealt with under Section 57, Education Act, 1944 3 Cases de-notified under Section 57(a) Education Act, 1944 Nil 123 REPORT OF THE PRINCIPAL SCHOOL DENTAL OFFICER Dental Inspections at School To inspect 100% of the children in the schools each year is the aim of the Dental Surgeons in this Borough, yet each year this is not achieved; to obtain such a result it would be necessary to have a full staff working throughout the year. This has not been the case over past years and again in 1969. Whilst difficulties in recruitment exist, it is impossible to obtain a full 100% inspection rate.
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Staff As indicated above the staffing position in the Dental Service generally presented problems which were only partially solved by the redeployment of staff to areas where the need was greatest. It is regrettable that whole time staff find the School Dental Service less attractive than private practice. Residential School The children of Swaylands Residential School continued to have a full and comprehensive Dental Service provided. Ages 5-9 Ages 10-14 Age 15 & over Attendances and Treatment: First visit 3972 3163 698 Subsequent visits 6054 7133 1610 Total visits 10026 10296 2308 Additional courses of treatment commenced 341 137 32 Fillings in permanent teeth 2572 5317 1746 Fillings in deciduous teeth 6548 633 - Permanent teeth filled 2205 4822 1542 Deciduous teeth filled 6143 588 - Permanent teeth extracted 96 328 127 Deciduous teeth extracted 1579 771 - General anaesthetics
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529 287 17 Emergencies 292 124 28 Prosthetics: Pupils supplied with full upper or lower (first time) β€” - - Pupils supplied with other dentures (first time) 5 8 16 Number of dentures supplies 5 8 16 124 Number of pupils X-rayed 965 Prophylaxis 1,321 Teeth otherwise conserved 2,960 Number of teeth root filled 32 Inlays 7 Crowns 87 Courses of treatment completed 5,817 Orthodontics: New cases commenced during year 277 Cases completed during year 159 Cases discontinued during year 110 Number of removable appliances fitted 554 Number of fixed appliances fitted 43 Pupils referred to Hospital consultant 3 Anaesthetics: General anaesthetics administered by Dental Officers 73 Inspections: (a) First inspection at school Number of pupils 27,978 (b) First inspection at Clinic Number of pupils 1,
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576 Number of (a) and (b) found to require treatment 11,545 Number of (a) and (b) offered treatment 10,138 (c) Pupils re-inspected at school or clinic 491 Number of (c) found to require treatment 256 SESSIONS Sessions devoted to treatment 4,024 Sessions devoted to inspection 282 Sessions devoted to dental health education 20 125 GENERAL SERVICES GENERAL SERVICES Health Education Man, as one living organism amongst others, is learning to control his environment and master many diseases. Undoubtedly, new and vastly improved standards of environmental, physical and mental health, are within reach, but lack of self control threatens him with disaster. The conquest of many of the current scourges of mankind demand personal participation; they are concerned with the moulding of attitudes and the correction of behaviour, so that we avoid modes of living which are injurious to health and foster those which promote the best standards of health.
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An important aspect of public health is to increase the intelligent responsibilities of the individual for his own health and that of his community. To encourage this area of responsibility in the individual is the prime function of the Health Education Section. Health Education in Clinics Relaxation and Parentcraft Classes The parents understanding of the physical, mental and emotional needs, of full development, of the infant and young child is the aim of the Health Visitors who take classes in relaxation and parentcraft in the clinics. In some instances evening sessions are arranged when husbands can attend with their wives. Also for expectant mothers and their husbands the Swedish film "Barnet" (The Child) was shown on alternate months at two parts of the Borough. Mothers Discussion Groups In an ever changing environment, problems which confront mothers concerning themselves, their children and family life need to be discussed and in the mothers and toddlers groups held in many clinics such an opportunity is afforded. Many health subjects were covered with support given by the Health Education Section.
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Clinics for the Elderly Assistance has been given by the officers of the Health Education Section in the compilation of programmes, suitable for the elderly and in the provision of visual material. These clinics are appreciated by the old folks who enjoy receiving some mental stimulation and an interest outside of themselves. 129 Health Education in Schools Today a child's education is related to living; he learns through the opportunity of reasoning rather than the presentation of facts, and in health education this principle of helping a child to relate biological facts to everyday life and experience has been pursued. Throughout runs the theme that health behaviour is a matter of personal choice. In Primary Schools the syllabus has been arranged to meet the needs of the particular school but in all cases the basic elements of good health i.e. physical, mental and social health and the responsibility of the individual towards this state, have been presented. The pupils in the Secondary Schools have investigated their future responsibility for their own health, their contribution to community health and their role as parents-to-be.
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Within this context of health responsibility information was given on the health hazards of today, namely lung cancer, obesity, venereal diseases, drug abuse, mental health and parentcraft. In one school, following a mothercraft course the interest shown in child care by the girls participating resulted in their forming a one afternoon per week play group for toddlers which provided an excellent opportunity for the girls to study child development at first hand. An interesting and very well worthwhile development has been an increased participation in Parent-Teacher meetings, especially to discuss with them the sex instruction which is included within the overall context of health in the school health programme.
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Below are details of the school courses which were undertaken during the year:- Primary Schools 10 β€” 11 year old pupils Full Year's Courses 7 Two Term Courses 3 Short Courses 2 8 β€” 9 year old pupils Two Term Courses 2 Secondary Schools 13 β€” 15 year old pupils Full Year's Courses 7 Two Term Courses 1 Occasional Talks 3 130 Grammar Schools 16 β€” 18 year old pupils Short Courses 2 Occasional Talks 5 Special Schools (Educationally Subnormal, Junior Training Schools) Short Courses 2 Health Education in other Organisations Requests were received from time to time from local organisations for talks or films on health topics, and these requests have been met, since education in small groups is most likely to have lasting results.
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A synopsis of these talks is given below:- Groups requesting Talks Youth Organisations 39 Women's and Men's Organisations 28 Young Wives Group Parent/Teacher Associations 9 Old People's Groups 12 Synopsis of subjects covered First Aid 6 Child Health 4 Nutrition 2 Sex Education 7 Mental Health 2 Health of the Elderly 11 Home Safety 36 Junior Mothercraft 5 Home Nursing 4 Environmental Health 4 102 Films shows were given. General Publicity With today's overwhelming amount of visual material to be seen wherever one turns one would expect that there is no room for anything further, but the display of posters and the availability of leaflets does provide a useful media for health education. 131 Using this media the monthly programme of health subjects was continued and posters and leaflets covering these subjects distributed to all Borough establishments. For special campaigns, posters were provided for the public notice boards. Special publicity was given for Fireworks and Christmas safety.
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Displays and Exhibitions There was less opportunity for displays this year as the window of Gateway House, 322 Regents Park Road, N.3, was not often available. Displays were exhibited as follows:- July Home Safety Finchley Carnival A float was also entered in the procession August Home Safety The Summer Show October Smoking Gateway House November Fireworks Safety Gateway House Campaigns There were no large scale campaigns organised this year. Other Activities Smokers Advisory Clinic The first clinic to help smokers to relinquish the habit was organised in October using the Five Day Play in co-operation with the British Temperance Society. This was well attended with the final results, obtained after the reunion of participants, giving a 50% success rate. Home Safety General Publicity The quarterly campaigns of R.O.S.P.A. were followed with posters and leaflets being distributed locally. Barnet Civic News The cartoon illustrating "Home Safety Tips" was prepared for each issue of Barnet Civic News. Outside Talks A number of requests for talks on Home Safety was received.
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These were from a 132 variety of groups, including old people's clubs, young wives groups and youth organisations as well as instruction to St. John's Ambulance Brigade and the British Red Cross Society. Campaigns Disposal of Medicines Campaign This campaign organised to persuade the public to dispose of old medicines and tablets to their local chemist was again organised in April β€” spring cleaning time. The material returned was collected for disposal, and it was first counted and weighed; some 26,000 tablets were destroyed. An effort was made to identify the tablets in order that the cost of the amount wasted could be assessed but this was considered to be an almost impossible task. The main aim of the campaign was to protect the young and others from the dangers of having medicines and tablets lurking in the homes in the community. Finchley Carnival and the Summer Show These two events again provided a means of promoting Health Education to a captive audience.
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This year the theme of the float in the carnival procession was the "Old Woman who lived in a Shoe" depicting a giant size old boot with children spilling out from it, all involved in some kind of home accident. In the marquee, 40 feet of space was devoted to displays concerning different aspects of home safety, with a moving film-let to attract attention, a game and competition for children; approximately 1,000 children entered during both shows. These occasions are a good opportunity for the distribution of home safety handbooks. Guy Fawkes Night A few days before bonfire night a decorated car with loudspeaker toured certain areas of the Borough urging the public to take care to avoid accidents. This year saw a substantial reduction in the fireworks accident rate, due without doubt to the intense television publicity given, and even the small local effort may have contributed to local results. Inter-Senior-Schools β€” Home Safety Quiz The Home Safety Quiz in senior schools was launched during the Autumn term.
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All schools were circulated and those entering teams were provided with all home safety information. The preliminary, semi-final and final rounds are planned for the Spring term of 1970. Cliff Richard, star of stage, films and television agreed to act as Question Master for the final round 133 SPECIAL INVESTIGATION CLINIC The Special Investigation Clinic continued to receive a large number of referrals, but although the total number of sessions in 1969 was slightly less than 1968, the average number of patients appointed per session rose from 16 in 1968 to 23 in 1969. There was also a 29% increase in the total number of attendances as compared to 1968 and an approximate 30% increase in the number of discharged patients between the two years. The relapse rate for 1969 was 28% whereas 31% is the total relapse rate for the three years of the clinic's existence.
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These figures are good in relation to conditioned learning treatment and are reflected in the good attendance rate at the clinic. There are several research projects operating, and these include studies on intensity/tone conditioning, personality factors, and prognosis, and the relation of over-learning to recurrence of enuresis. Mr. R.K. Turner, voluntary Psychologist at the clinic was awarded the degree of Ph.D. (London) for a thesis concerned with learning theory procedures used in the treatment of Enuresis. Mr. Turner was appointed as Principal Psychologist, Hollymoor Hospital, Birmingham; he does, however, still maintain contact with the clinic and visits at regular intervals. Dr. Young, Deputy Medical Officer of Health, published a paper "The Problem of Enuresis". Ref.(1969) Brit.J.Hosp.Med 2. 628-632. Statistics Year Ending 31.12.69 BOYS GIRLS TOTAL No.
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of new patients seen: Under 5 14 8 22 5-9 64 37 101 10 β€” over 40 10 50 Total 118 55 173 Total attendances: 1109 422 1531 No. of 1st appointment failures 33 23 56 Total appointment failures 471 216 687 Referrals Under 5 23 12 35 5-9 86 56 142 10 & over 44 15 59 Total 153 83 236 Discharged Cases (of these, discharged for second/third time) 115 51 166 24 11 35 Relapsed cases.
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Discharged 1967: - - - Discharged 1968: 15 10 25 Discharged 1969: 27 10 37 Total 42 20 62 Total Sessions: 97 Total Appointments 2218 Average Appointed Number/Session: 23 134 ESTABLISHMENTS FOR MASSAGE AND SPECIAL TREATMENT The total number of establishments registered at the end of the year under Part XII of the Middlesex County Council Act, 1944, was 32. PERSONS IN NEED OF CARE AND ATTENTION Provision is made under Section 47 of the National Assistance Act 1948 as amended by the National Assistance (Amendment) Act 1951 for securing the necessary care and attention in hospital or other place, e.g. residential accommodation provided under Part III of the Act, for persons who are infirm or suffering from a serious chronic disease and who are unable to give themselves sufficient care nor are receiving it from other sources.
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It became necessary to apply this statute in respect of one case in March 1969, when a man living alone was found to be ill and suffering from gross malnutrition. He persistently refused to enter hospital. A Magistrate's order had to be obtained to compel him to enter Edgware General Hospital where he made a complete recovery and went to live with his sister on his discharge. BURIAL AND CREMATION It is the duty of the local authority under Section 50 of the National Assistance Act 1948 to cause to be buried or cremated the body of any person who has died in or been found dead in the area, in any case where it appears to the authority that no suitable arrangements for the disposal of the body have been or are being otherwise made. The expenses incurred may be recovered from the estate of the deceased person, by death grant subject to the contribution conditions being satisfied, or from any person who for the purposes of the act was liable to maintain the deceased person immediately before death.
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Four cremations or burials were carried out during the year. CREMATION CERTIFICATES The Medical Officer of Health, Deputy Medical Officer of Health and a Principal Medical Officer are appointed Medical Referees under the Cremation Acts 1902 and 1952. During the year 1085 Certificates were examined and approved. DOMICILIARY LAUNDRY SERVICE This is a service to assist families to care for the elderly, or to nurse chronically sick people of any age at home. A once a week collection and delivery is dealt with by the Department, and the cleansing and laundering of soiled linen and clothing is carried out at Colindale Hospital. 135 This service is much appreciated by all who use it and thanks are due to the Hendon Group Hospital Management Committee for their co-operation. At the end of the year 35 persons were receiving assistance. MEDICAL ASSESSMENTS AND EXAMINATIONS (Staff Health Service) During 1969 this Service continued to expand.
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There was an overall increase in the number of assessments dealt with and in the number of medical examinations carried out. In this latter respect the number more than doubled last year's figure. There was an increase in the number of persons employed under the Disabled Persons' Employment Acts 1944 and 1958 from eight persons in 1968 to twenty persons in 1969; all of these were also medically examined. Fifteen medical examinations were carried out in respect of staff with prolonged absence due to illness and with a view to ascertaining whether or not they were fit to undertake the duties of their posts or to be subject to early retirement. In eleven cases it was found that the staff should be subject to premature retirement on the grounds of permanent ill health. Below are the figures in respect of medical assessments and examinations carried out during the year- No. of medical forms assessed 2166 No. of medical examinations β€” Barnet 124 β€” other authorities 9 No.
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of medical examinations carried out under Ministry of Education Circular 249/52:- (a) Teachers' first appointments 79 (b) Entrants to Training College 326 Total No. of medical examinations performed 573 DEPARTMENTAL SPECIAL TRANSPORT Council Transport The Borough Engineer and Surveyor has seven special purpose built vehicles available to cover the transport needs of the Health and Welfare Department. Details of the vehicles and their duties are as follows:- 136 12 Seater Coach (or 4 wheelchairs) This vehicle is used for the Hendon Work Centre, Heriot Road, N.W.4. daily from 7.30 a.m. until 9.30 a.m. On Monday, Wednesday and Friday it is used for a bus service from certain homes in the N.W.ll. district from 10 a.m. to 12 noon. The Day Centre for the Elderly at Claremont Clinic, N.W.2.
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is held on Tuesday and Thursday and the coach is used for this purpose from 10 a.m. to 12 noon and 4 p.m. to 5.30 p.m. The coach transports handicapped persons from the Hendon Work Centre on Monday, Tuesday and Thursday afternoon from 12.30 p.m. to 3.30 p.m. 24 Seater Coach (or 10 wheelchairs and 5 other passengers) This coach is assigned to the Hendon Work Centre each day except Thursday. On Wednesday the Work Centre's afternoon's journey is extended to include a party from the British Red Cross Society. This Society uses this vehicle on Thursday from 12.30 p.m. to 6.30 p.m. Additionally on Monday, Wednesday and Friday this coach assists in the bus service in the N.W.ll district referred to above.
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12 Seater Coach (or 4 wheelchairs) Used exclusively Monday to Friday by the Deansbrook Rehabilitation Centre, Edgware (7.30 a.m. to 6.30 p.m.) Because of the numbers involved the coach makes two journeys. 12 Seater Coach (or 4 wheelchairs) Used by the Fieldways Adult Training Centre, Wellhouse Lane, Barnet, 7.30 a.m. to 6.30 p.m. Monday to Friday. 12 Seater Coach (or 4 wheelchairs) The Hendon Junior Training School at Flower Lane, N.W.7. uses this coach from 7.30 a.m. to 11 a.m. daily. In the afternnon the return journey (3 p.m. to 6.30 p.m.) is combined with the British Red Cross Society's party from The Downage, N.W.4.
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12 Seater Coach (or 4 wheelchairs) Used for taking children to the Friern Barnet Junior Training School, Oakleigh Road, N.20 each morning from 7.30 a.m. to 11 a.m.) The return journey commences at 2.30 p.m. and finishes at 6.30 p.m., but on Monday, Thursday and Friday the return starts at 12.30 p.m. as the coach also assists in the transport of Handicapped Persons from Hendon Work Centre. 12 Seater Coach (or 4 wheelchairs) Used exclusively each day by the Etchingham Park Workroom/Day Centre. Because of the difficulty of fitting in all the department's jobs in the daily run of a particular coach, Park House Day Centre, Monday 10.30 a.m. to 12.30 p.m. and 3.30 p.m. to 5.30 p.m.
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and the Cookery Class for the Blind at Barnet Technical College on Fridays (during term time) 8.30 a.m. to 2.30 p.m. are covered by the allocation of any 137 suitable vehicle available from the Transport Section of the Borough Engineer and Surveyor's Department. By long standing agreement the Counci 1 provide transport during the evenings for the following voluntary bodies and associations (a) Blind Dancing Class, St. David's School, Park Road, Hendon β€” Monday 6.30 p.m. to 11.30 p.m. (b) Starfish Swimming Club, Hamsptead Swimming Baths, Swiss Cottage β€” Tuesdays 5.30 p.m. to 11.30 p.m. (c) Happy Social Club, Conservative Hall, Edgware β€” 2nd Wednesday in each month 6.30 p.m. to 11.30 p.m. (d) Choral Class, Percy Road, N.2.
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- Wednesday 6.30 p.m. to 11.30 p.m. (e) Multiple Sclerosis Society, Mill Hill Clinic β€” Thursdays 6.30 p.m. to 11.30 p.m. The Borough Engineer and Surveyor's Department supply cars if available to convey persons in the care of the Department provided the passengers are not physically handicapped. Hired Transport During 1969 as in previous years, the Council hired transport to carry out additional commitments over and above the capability of its own vehicles. TRAINING COURSES AND STUDENT ATTACHMENTS During 1969 a wide variety of training courses, refresher courses, conferences and study days were made available to the staff of the Department. Continued use was made of the facilities offered by the London Boroughs' Training Committee, The Senior Assistant Nursing Officer, was successful in obtaining a scholarship to the Administrative Staff College, Henley-on-Thames, being sponsored by the Health Visitors' Association, and was granted leave of absence for eleven weeks.
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Courses and study days attended by staff embraced the following subjects.
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Diploma in Public Health Diploma in Municipal Administration Social Work Course leading to the National Certificate Diploma Course for Teachers of Mentally Handicapped Children Refresher Course for Teachers of Mentally Handicapped Children Study Days, Conferences and Seminars covering various aspects of Mental Health 138 Course for Head Teachers of Junior Training Schools Course for Staff of Adult Training Centres Conference for Matrons of Day Nurseries Developmental Paediatrics Assessment of Handicapped Children Courses for Social Workers with the Deaf District Nurse Training Health Visitor Training Senior Home Nurses Training Medical Computer Courses Midwives' Refresher Courses Preparation for Childbirth Geriatrics Course for Matrons and Wardens of Old People's Homes Public Health in many aspects including the problems of Noise and Clean Air Home Safety Many aspects of Health Education A new course for Home Helps Home Help Organiser's Course Health Visitors The Authority's three health visitor students passed their examination and 6 others, sponsored by other authorities and who trained in the Authority's area, were also successful.
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Hospitality was offered to 3 health visitor students from rural areas who wished to gain experience in an urban area, 8 Child Care students accompanied health visitors in their work and a sociology student of Bedford College spent 2 weeks with the staff of the department. Assistance was also given to a student of Bedford College who was carrying out research work on health visiting services. 12 Health visitors took part in a programme of intensive research into the work of a health visitor organised by Dr. Benjamin of the Greater London Council. Midwives 23 pupil midwives from Edgware General Hospital received their district training in the Borough, one residing with a midwife and the others in the Nurses Home at Gervase Road, Edgware. 3 midwives attended statutory refresher courses. Home Nurses Home nurses participated in the training of hospital student nurses throughout the year, 96 of whom accompanied home nurses on visits for one day or half a day, 4 medical students spent a day in the Borough observing the work of the home nurses.
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139 9 home nurses attended training courses and were successful in obtaining the National Certificate for District Nurses, and 2 senior nurses attended a Practical Work Instructor's Course. Nursery Nurses The nursery nurse training course at the Barnet College of Further Education commenced its second year in September and the staff of the 3 day nurseries participated in the practical training of students attending the course. A full time health tutor was appointed to the course this year and maintained close contact with the day nursery matrons. Home Helps A training course for home helps commenced in September at the Barnet College of Further Education and proved very successful. 15 home helps at a time attended on one afternoon a week during the college term and, at the end of the course, received a Certificate in Health and Home Management. The home helps themselves are very enthusiastic about the scheme, as apart from the instruction, it provides them with an opportunity to get to know each other and discuss their various problems.
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In-Service Training In my report for 1967 I referred to the introduction of a departmental In-Service Training Course which latterly has been held at six month intervals. Since its inception, five series of lectures have been arranged and in addition to a number of staff from other departments, 152 members of the Health and Welfare Department have attended; in the main the proj ect has been acclaimed as a useful contribution to basic training and a worthwhile means of disseminating information on local organisational and administrative policies.
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Lectures on the under-mentioned subjects were given by Principal and Senior Officers and Officers of other departments involved in Social Services What Local Government is and how it works in Barnet Principles and Aims of Administration Budgetary Control and Statistics The Work of the Public Health Inspector The Control of Infectious Disease The Public Health Dental Services The Mental Health Services The Role of the Mental Welfare Officer Welfare Services in the Community Residential Care in the Welfare Services The Problems of Homelessness Children in Care A Municipal Housing Department 140 Public Health β€” Allied Nursing Services The Child Health Services The School Health Services Health Education as a service in the Borough I am appreciative of the time given by the Officers concerned, the high standard of lectures and extend my grateful thanks to the Town Clerk, the Borough Housing Officer and the Borough Children's Officer for their participation. In addition, other In-Service Training projects were organised with the Health Education Section of the department e.g.
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a Study Day for Clinic Nurses technique of small display making, designed to assist them in poster display and the making of small clinic displays; a three day course for Health Visitors and Midwives on Psychophysical preparation for Child Birth. 141 INDEX INDEX PAGE A Aids and Adaptations 88 Animals 62 Ante-Natal Clinics 93 Audiology 115 Audiometry 114 B BCG Vaccination 106 Births and Birth Rates 11,16,18,19,20,89 Blind and Partially Sighted 82,83,84,85 British Red Cross Society β€”Loan of Equipment 97 Burial and Cremation 135 c Cancer 18 Caravans 55 Care of Mothers and Young Children 92 Care of the Unsupported Mother 103 Cervical Cytology 104 Chest Clinics 102 Child Development Study 118 Child Guidance Service 115 Child Minders 1,98 Child Welfare Centres 95 Chiropody 98 Clean Air 29,
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43 Clearance Areas 46 Clinics for the Elderly 98,129 Clinic Premises 95 Committee Members 7 Common Lodging Houses 50 Complaints β€” Environmental Health 55 Compulsory Improvement Areas 48 Congenital Malformations 94 Contents 5 Cremation Certificates 135 D Day Centres for the Elderly 80 Day Centres for the Mentally 111 70 Day Nurseries 97 Day Nurseries, Private & Registered Child Minders1, 98 Deaf and Hard of Hearing 86 Deaths and Death Rates 12 .13.14,15.17.18,21,22 Dental Services, Priority 101 Disinfection and Disinfestation 124 Domiciliary Laundry Service 135 E Elderly Persons 79 Enuresis 1 Environmental Health Services 29 PAGE Establishments for Massage and Special Treatment 135 Exhumations 65 F Factories and Work Places 58 Family Planning 1,104 Food 29 Food β€” Complaints 36 Food Hygiene 39 Food Samples,
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Formal and Informal 30 Food Unfit for Human Consumption 38 G General Practitioner β€” Staff Attachments 1,91 General Services 129 H Handicapped Pupils 119 Hawkers 40 Health Education 129 Health Visitors 139 Health and Welfare Committee 7 Holiday Homes β€” Recuperative 99 Homes for the Elderly and Handicapped 79 Home Help Service 2,97,140 Home Nursing 96,139 Home Safety 132 Home Tuition β€” School Children 101 Home Visiting 91,92 Homelessness 1,81 Hospital and General Practitioner Services 91 Hostels β€” Mental Health 70 Houses in Multiple Occupation 50 Housing 1,29,45 Housing Accommodation 45 Housing β€” Area I mprovement 48 Housing β€” Improvement 47 Housing β€” Statistics 53 I Ice Cream 35 Immunisation and Vaccination 26,
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105 Improvement Areas 48 Incontinence Pads and Clothing 97 Incontinence Laundry Service 135 Individual Unfit Houses 46 Infectious Diseases 25 In-Service Training Course 140 Inspections β€” Environmental Health 55 International Certificates of Vaccination 26 J Junior Training Schools 72 145 PAGE L Labelling of Food 41 Land Charges 57 Laundry Service 135 Legal Proceedings 42 Liquid Egg 35 Loan of Nursing Equipment 97 M Marie Curie Memorial Foundation 96 Markets 40 Massage and Special Treatment 135 Measles Vaccine 105 Medical Assessments and Examinations 136 Medical Inspections and Treatment (Schools) 173,114 Mental Health β€” Case Work 69 Mental Health β€” Hostels 70 Mental Health β€” Preventative Work 71 Mental Health β€” Residential Care 73 Mental Health Services 69 Mental Health Social Clubs 70 Mental Illness 69 Midwifery 96,139 Milk β€” Registration,
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Licensing and Sampling 35 Mortuaries 65 Mother and Baby Home 92 Mothercraft and Relaxation Clinics 94,129 Mothers' Discussion Groups 94,129 N Napsbury Hospital 71 National Child Development Study 118 Neighbourly Help Service 97 Noise 57 Nursery Nurses 140 Nurses' Agencies 100 Nursing Homes. Registration 99 O Offices and Shops 57 Ophthalmic Clinics 114 Outworkers 60 Overcrowding 49 P Paratyphoid Fever 26 Partially Sighted and Blind 82,83,84,85 Personal Health Services 91 Persons in Need of Care and Attention 135 Pesticide Survey 42 Physically Handicapped Persons 87 Post-Natal Clinics 94 Poultry I nspection 40 Prevalence and Control of Infectious and Other Diseases 25 Prevention of Homelessness (Problem Families). 92 PAGE Psychiatric Hospitals 71 R Rag,
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Flock and Other Filling Materials 60 Recuperative Holiday Homes 99 Refuse Collection and Disposal 62 Relaxation and Mothercraft Clinics 94,129 Rent Control 52 Residential Accommodation β€” Welfare Services 79 Residential Care β€” Mental Health 73 Rodent Control 63 s Sanitary Conveniences 61 School β€” Special Transport 121 School Dental Service 124 School Health Service 113 School Medical Inspection and Treatment Treatment 113,114 School Population 113 Sewerage and Sewage Disposal 61 Shops and Offices 57 Short Term Care β€” Mental Health 73 Slaughter Houses 40 Slum Clearance & Redevelopment 47 Smallpox Vaccination 26,107 Smoke Control 29,43 Special Investigation Clinic 1.134 Speech Therapy 118 Staff 8 Staff Health Service 136 Staff Training 2,138 Statistics β€” Housing 53 Mental Health Service 74 School Health Service 121,122,123 Vital 1,11 Stillbirths 12,21,
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22 Student Attachments 138 Swimming Pools 60 T Temporary Accommodation 81 Training Courses and Student Attachments 138 Transport (Departmental) 136 Transport (Schools) 121 Tuberculosis 102 Tuberculosis BCG Vaccination 106 Typhoid Fever 26 V Vaccination and Immunisation 26,105 Vital Statistics 1,11 w Water Supply 30 Welfare Services 79 Whooping Cough Vaccination 107 146 Printed and Published by Barnet London Borough Council
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BAR 4 I THE HEALTH AND WELFARE OF THE LONDON BOROUGH OF BARNET 1970 MELVILLE WATKINS, M.R.C.S., L.R.C.P., D.P.H. THE LONDON BOROUGH OF BARNET ANNUAL REPORT OF THE MEDICAL OFFICER OF HEALTH AND PRINCIPAL SCHOOL MEDICAL OFFICER FOR THE YEAR 1970 MELVILLE WATKINS, M.R.C.S., L.R.C.P., D.P.H. Health and Welfare Department, London Borough of Barnet, Gateway House, 322 Regents Park Road, Finchley, N.3, The Mayor, Aldermen and Councillors of the Council of the London Borough of Barnet. It is with pleasure, though somewhat belatedly, that I present my Report on the Health and Welfare services of the Borough for the year 1970.
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With the introduction of the Social Services Act 1970 effective from the 1st April, 1971, the year proved to be one of considerable involvements, not the least of which was that of considering staff who would be transferred by reason of the work undertaken by them to the new Social Services Directorate. With a combined Health and Welfare Department which saw the integration of Health and Welfare services under a common executive and management structure, the assimilation of fragmented posts presented many problems for the future Health administration. The organisation of the Department since April 1965 had, I think, proved an efficient and economical one and the services being provided were, having regard to the availability of resources, able to meet the major needs of the community. The developments planned and which had been approved by the Council for Health and Welfare projects were far seeing and formed the nucleus of a realistic service provision in the years to come. For this reason the new Social Services Directorate would have a solid basis of developments on which to build their future structure.
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Examples of projects commenced under Health and Welfare were the Old People's Homes to be built at Perryfields, West Hendon, Brunswick Park, New Barnet and Grahame Park. In addition, the planning of a Day Centre for the elderly mentally infirm at Meadowside had been approved in principle and a 60 place workshop for the mentally handicapped was to proceed at Broadfield Estate, Edgware, plus a 150 place adult training centre, a Hostel for the mentally handicapped, and later a day centre for elderly mentally infirm. Other projects for development within the years immediately following 1970 were an Old People's Home at Vale Farm and a Hostel for elderly mentally infirm at Brunswick Park Road, East Barnet. Additional projects planned for Grahame Park were a Welfare Centre for the physically handicapped, etc., and a 60 place Day Nursery.
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Many other schemes for development of the welfare and mental health services were forecast and though, in some instances, the sites could not be firmly determined, much progress had been made at various levels to further the projects ultimately becoming viable schemes. 1 It is always sad to see the break up of a department which can rightfully claim a fair measure of success, and all I can hope is that the implementation of the new legislation which includes the Chronically Sick and Disabled Persons Act, will provide residential and community services which will meet the needs of the Borough. The problem of homelessness has continued to present difficulties and I envisage that there will always be a demand for additional units of accommodation within the foreseeable future. The conversion of Manor Cottages, Finchley, N.2. to provide additional units should go some way towards relieving the problem.
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In regard to family planning, 1970 saw considerable progress being made in the provision of a comprehensive service, but here again, it appears obvious to me that this is a service which will continue to expand with ever increasing demands being made. The development of health centres continues and the first one was opened at East Barnet in January, 1970. Although not a purpose built Centre, the extension of the East Barnet Clinic and adaptations made within the premises have provided a most viable unit. The interest of General Medical Practitioners continues and I foresee that in the not too distant future, health centres (purpose built) will be required in a number of districts within the Authority's boundaries and furthermore, there will be a need to extend and equip existing clinics to provide health centre accommodation. This is a priority service insofar as the Government is concerned and the provision of such establishments does much to provide for total health care within the community.
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From the statistical tables shown on pages 11 to 23 it will be seen that the number of live births has continued the decrease which began in 1964, the corrected birth rate in 1970 having fallen to 12.9 per 1000 population, from 13.2 in 1969. The illegitimate birth rate has increased from 6.9% of all live births in 1969 to 7.4%, reversing the downward trend of the previous four years. There were 57 stillbirths, a rate of 13,7 per 1000 live and stillbirths, as against 50 stillbirths in 1968, a rate of 11.8. The infant (under one year) death rate per 1000 live and stillbirths showed a substantial increase at 17.8 over the 1969 rate of 12.8; the longterm trend however continues to be downward.
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The neo-natal death rate rose from 8.6 to 13.4, the early neo-natal death rate from 7.2 to 11.2, and the pre-natal death rate (stillbirths and deaths under one week of age) from 23.4 to 24.8. Deaths from all causes decreased from 3,664 in 1969 to 3,582, the corrected rate per 1000 population falling from 10.6 to 10.5. There was no serious outbreak of infectious disease during the year. A number of visits were paid to the Department by representatives of the various professions who were anxious to obtain the views of staff employed in the various divisions of the Department and responsible for particular services. 2 The Minister of State, Health, Lord Aberdare was also a visitor to the Borough in September 1970 and included in his itinerary a visit to East Barnet Health Centre.
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As I have often said before, for any department to be successful there must be team work and personal involvement of individuals, and during 1970 this was most apparent, and I thank all members of the staff for the part that they played. Finally, I wish to pay tribute to the valuable services rendered by the Voluntary Organisations and voluntary helpers, and to express with deep sincerity my appreciation of the support given to me by the Chairman, Vice-Chairman and members of the Health and Welfare Committee. I also acknowledge with gratitude the continued co-operation of my fellow Chief Officers and their Staffs.
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M. WATKINS Medical Officer of Health 3 CONTENTS Page COMMITTEE MEMBERS, CHIEF AND SENIOR OFFICERS 7 VITAL STATISTICS 11 PREVALENCE AND CONTROL OF INFECTIOUS AND OTHER DISEASES 27 ENVIRONMENTAL HEALTH SERVICES 31 MENTAL HEALTH SERVICES 73 WELFARE SERVICES 83 PERSONAL HEALTH SERVICES 97 SCHOOL HEALTH SERVICES 117 GENERAL SERVICES 135 INDEX 151 5 HEALTH AND WELFARE COMMITTEE as at 31st December, 1970 Councillor Mrs. R.A. Freedman (Chairman) Councillor H.R. Brooks (Vice-Chairman) COUNCILLORS: E.A.E. Asker, J.P., F.C.I.S., A.B.A.A., (Mayor), F.J. Collisson, R.J. Finigan, B.Sc. (Econ.), Mrs. 3.M. Franklin, Mrs.
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E.R. Gibson, W.C. James, J.E. Park, F.C.A., J.S. Payne, Mrs. C. Riordan, R.R. Stewart, LL.M., Mrs. M.M. Symons, Mrs. Clara Thubrun, M.B.E., J.P., J.C. Tiplady, V.H. Usher. Co-opted Member: Dr. T.J. Carter, M.R.C.S., L.R.C.P. 7 STAFF OF THE HEALTH AND WELFARE COMMITTEE as at 31st December, 1970. M. Watkins, M.R.C.S., L.R.C.P., D.P.H. Medical Officer of Health G.C. Young, M.D., M.B., S.Ch., B.Sc., D.P.H., L.M.S.S.A. Deputy Medical Officer of Health R.C.
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Greenberg, M.B., B.S., D.P.H., D.M.J. (Clin.), Mem. Brit. Acad. Forensic Sc. Joan Mulholland, M.B., Ch.B., D.P.H., D.C.H. Mary McQuaid, L.R.C.P., L.R.C.S., D.P.H. Principal Medical Officers Hannah Mushin, M.R.C.S., L.R.C.P., D.C.H. Gillian S. Simmons, M.B., Ch.B., M.R.C.S., L.R.C.P., D.R.C.O.G. Lysbeth R. Vaughan-Jones, L.R.C.P.S., L.R.F.P.S. Senior Medical Officers J.E. Wilson, D.C.M., B.Sc. (Econ.) A.A.P.S.W. (Resigned 30.11.70) Principal Welfare Officer Mrs. J.M.A.W.
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Foulkes, S.R.N., S.C.M., H.V. Principal Nursing Officer R.L. James, L.D.S., R.C.S. Principal Dental Officer Miss E. Johnston, S.R.N., S.C.M., Q.N., H.V. Health Education Officer and Home Safety Organiser C.H. Machin, A.M.R.S.H. Principal Administrative Assistant K.J. Millen, M.R.S.H., F.A.P.H.I. Principal Public Health Inspector W.J.A. Ward, M.S.M.W.O. Principal Mental Welfare Officer 8 STATISTICS STATISTICS Area (in acres) 22,124 Population β€” Registrar - General's Estimate Mid 1970 313,080 Number of Inhabited Dwellings, 1st April, 1970 - Houses and Flats 100,838 Other properties with living accommodation 738 Rateable Value at 1st April, 1970 Β£22,779,
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527 Product of penny rate 1970/71 Β£90,600 LIVE BIRTHS MALES FEMALES TOTAL Legitimate 1,973 1,816 3,789 Illegitimate 156 145 301 2,129 1,961 4,090 Illegitimate live births per cent, of total live births BARNET 7.4 GREATER LONDON 11.3 INNER LONDON 16.2 OUTER LONDON 8.3 ENGLAND AND WALES 8.3 Live Birth Rate per 1,000 population:- BARNET 13.1 AREA COMPARABILITY FACTOR 0.99 CORRECTED RATE -BARNET 12.9 GREATER LONDON 14.1 INNER LONDON 14.0 OUTER LONDON 14.3 ENGLAND AND WALES (PROVISIONAL) 16.
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0 11 STILLBIRTHS MALES FEMALES TOTAL Legitimate 28 25 53 Illegitimate 3 1 4 31 26 57 Total live and stillbirths 2,16(1 1,987 4,147 Stillbirth rate per 1,000 live and stillbirths LEGITIMATE ILLEGITIMATE TOTAL BARNET 13.8 13.1 13.7 GREATER LONDON 12.0 INNER LONDON 12.1* OUTER LONDON 11.9* ENGLAND AND WALES (PROVISIONAL) 12.8 15.9 13.0 *Figure based upon less than 1,000 occurrences INFANT DEATHS (under 1 year of age) MALES FEMALES TOTAL Legitimate 40 23 63 Illegitimate 5 5 10 45 28 73 Infant death rate per 1,
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000 live births:- LEGITIMATE ILLEGITIMATE TOTAL BARNET 16.6 33.2 17.8 GREATER LONDON 17.8 INNER LONDON 20.4* OUTER LONDON 16.3 ENGLAND AND WALES 17.2 25.9 18.2 *Figure based upon less than 1,000 occurrences 12 NEO-NATAL DEATHS (under 4 weeks of age) MALES FEMALES TOTAL Legitimate 30 15 45 Illegitimate 5 5 10 35 20 55 Neo-Natal death rale per 1,000 live births:- LEGITIMATE ILLEGITIMATE TOTAL BARNET 11.9 33.2 13.4 GREATER LONDON 12.3 INNER LONDON 13.5* OUTER LONDON 11.6* ENGLAND AND WALES 11.6 17.4 12.3 *Figure based upon less than 1,
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000 occurrences EARLY NEO-NATAL DEATHS (under 1 week of age) MALES FEMALES TOTAL Legitimate 24 13 37 Illegitimate 5 4 9 29 17 46 . Early Neo-natal death rate per 1,000 live births:- LEGITIMATE ILLEGITIMATE TOTAL BARNET 9.8 29.9 11.2 GREATER LONDON 10.7 INNER LONDON 11.9* OUTER LONDON 10.0* ENGLAND AND WALES (PROVISIONAL) 10.2 15.2 10.6 *Figure based upon less than i,000 occurrences 13 PERI-NATAL DEATHS (Still births and Deaths under 1 week of age) MALES FEMALES TOTAL 52 38 90 Illegitimate 8 5 13 60 43 103 Peri-natal death rate per 1,
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000 live and stillbirths:- LEGITIMATE ILLEGITIMATE TOTAL BARNET 23.4 42.6 24.8 GREATER LONDON 22.6 INNER LONDON 23.9 OUTER LONDON 21.8 ENGLAND AND WALES (PROVISIONAL) 22.8 30.8 23.5 MATERNAL MORTALITY RATES per 1,000 total live and still births:- Excluding Abortions BARNET NIL GREATER LONDON 0.17* INNER LONDON 0.25* OUTER LONDON 0.12* ENGLAND AND WALES (PROVISIONAL) 0.14 Including Abortions BARNET NIL ENGLAND AND WALES (PROVISIONAL) 0.18 *Figure based upon less than 100 occurrences 14 DEATHS FROM ALL CAUSES MALES 1,675 FEMALES 1,907 TOTAL 3,582 Death rate per 1,
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000 population:- BARNET 11.4 AREA COMPARABILITY FACTOR 0.92 CORRECTED RATE - BARNET 10.5 GREATER LONDON 11.4 INNER LONDON 11.7 OUTER LONDON 11.2 ENGLAND AND WALES 11.7 15 CAUSES OF, AND AGES AT. DEATH No. Cause of Death Total all ages Under 4 weeks 4 weeks and under 1 year Age in years 1 - 5 - 15- 25- 35- 45- 55- 65- 75 and over B4 Enteritis and other Diarrhoeal Diseases 2 1 β€” β€” β€” β€” β€” β€” β€” β€” 1 B5 Tuberculosis of Respiratory System 8 β€” β€” β€” β€” 1 β€” 1 β€” 2 β€” 4 B6(l) Late effects of Respiratory T.
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B 2 β€” β€” β€” β€” β€” β€” β€” β€” 1 β€” 1 B6(2) Other Tuberculosis 2 β€” β€” β€” β€” β€” 1 β€” 1 β€” β€” β€” B17 Syphilis and its Sequelae 1 β€” β€” β€” β€” β€” β€” β€” β€” β€” 1 β€” B18 Other Infective and Parasitic Diseases 5 1 β€” 1 β€” β€” 1 β€” β€” 2 β€” β€” B19(l) Malignant Neoplasm, Buccal cavity etc. 6 β€” β€” β€” β€” β€” β€” β€” 1 2 2 1 B19(2) Malignant Neoplasm, Oesophagus 8 β€” β€” β€” β€” β€” β€” β€” β€” β€” 2 6 B19(3) Malignant Neoplasm, Stomach 83 β€” β€” β€” β€” β€” β€” 2 6 14 22 39 B19(4) Malignant Neoplasm,
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Intestine 112 β€” β€” β€” β€” β€” β€” 2 7 31 22 50 B19(5) Malignant Neoplasm, Larynx 3 β€” β€” β€” β€” β€” β€” β€” β€” β€” 2 1 B19(6) Malignant Neoplasm, Lung, Bronchus 216 β€” β€” β€” β€” β€” β€” 5 18 54 84 55 B19(7) Malignant Neoplasm, Breast 88 β€” β€” β€” β€” β€” 1 2 20 28 16 21 B19(8) Malignant Neoplasm, Uterus 22 β€” β€” β€” β€” β€” β€” 2 1 8 4 7 B19(9) Malignant Neoplasm,
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Prostate 25 β€” β€” β€” β€” β€” β€” β€” 2 2 10 11 B19(10) Leukaemia 22 β€” 1 1 3 1 1 1 2 2 5 5 B19(ll) Other Malignant Neoplasms 215 β€” β€” β€” 1 5 4 14 24 46 56 65 B20 Benign and Unspecified Neoplasms 12 β€” β€” β€” 1 β€” β€” 2 1 2 2 4 B21 Diabetes Mellitus 19 β€” β€” β€” β€” β€” β€” β€” β€” 2 5 12 B22 Avitaminoses, etc 3 β€” β€” β€” β€” β€” β€” β€” β€” β€” β€” 3 B46(l) Other Endocrine etc. diseases 7 1 β€” 1 β€” β€” β€” β€” β€” 2 1 2 B23 Anaemias 9 β€” β€” β€” β€” β€” β€” β€” β€” β€” 2 7 B46(3) Mental
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Disorders 10 β€” β€” β€” β€” 1 β€” β€” 1 β€” 3 5 B46(4) Multiple Sclerosis 6 β€” β€” β€” β€” β€” 1 2 β€” 1 2 β€” B46(5) Other Diseases of Nervous System 27 β€” β€” β€” 1 β€” 1 2 4 4 5 10 B25 Active Rheumatic Fever 1 β€” β€” β€” β€” β€” β€” β€” β€” β€” β€” β€” B26 Chronic Rheumatic Heart Disease 50 β€” β€” β€” β€” β€” 2 2 5 13 9 19 B27 Hypertensive Disease 64 β€” β€” β€” β€” β€” β€” 2 β€” 13 13 36 B28 Ischaemic Heart Disease 882 β€” β€” β€” β€” β€” β€” 15 40 174 264 389 B29 Other forms of Heart Disease 163 β€” β€” β€” β€” 1 β€” 2 β€” 8 24 128 B30 Cerebrovascular Disease 437 β€” β€” β€” 1 1 β€” 3
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10 39 94 289 B46(6) Other Diseases of Circulatory System 161 β€” β€” β€” β€” β€” β€” β€” 7 20 31 103 B31 Influenza 22 β€” β€” β€” β€” β€” β€” β€” 1 5 6 10 B32 Pneumonia 324 3 6 1 β€” 2 1 2 4 20 57 288 B33(l) Bronchitis and Emphysema 149 β€” 1 β€” β€” β€” 1 1 1 14 41 90 B33(2) Asthma 11 β€” β€” β€” β€” β€” β€” 1 β€” 3 4 3 B46(7) Other Diseases of Respiratory System 34 β€” 4 β€” β€” β€” β€” β€” 2 4 6 18 B34 Peptic Ulcer 18 β€” β€” β€” β€” β€” β€” β€” β€” 3 5 10 B35 Appendicitis 2 β€” β€” β€” β€” β€” β€” β€” β€” β€” β€”
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2 B36 Intestinal Obstruction and Hernia 11 1 β€” β€” β€” β€” 1 1 β€” 1 β€” 7 B37 Cirrhosis of Liver 10 β€” β€” β€” β€” β€” β€” β€” 1 4 2 3 B46(8) Other Diseases of Digestive System 46 β€” β€” 1 β€” β€” 1 3 β€” 8 10 23 B38 Nephritis and Nephrosis 10 β€” β€” β€” β€” β€” 2 1 1 1 3 2 B39 Hyperplasia of Prostate 5 β€” β€” β€” β€” β€” β€” β€” β€” β€” 3 2 B46(9) Other Diseases, Genito-Urinary System 29 β€” β€” β€” β€” 1 β€” 1 2 3 4 18 B46(10) Diseases of Skin,
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Subcutaneous Tissue 2 β€” β€” β€” β€” β€” β€” β€” β€” 1 β€” 1 B46(ll) Diseases of Musculo-Skeletal System 20 β€” β€” β€” β€” β€” 1 2 2 7 3 5 B42 Congenital Anomalies 24 9 4 2 1 β€” 2 β€” 2 2 1 1 B43 Birth Injury, Difficult Labour, etc.
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18 18 β€” β€” β€” β€” β€” β€” β€” β€” β€” β€” B44 Other Causes of Perinatal Mortality 21 21 β€” β€” β€” β€” β€” β€” β€” β€” β€” β€” B45 Symptons and 111 Defined Conditions 9 β€” β€” β€” β€” β€” β€” β€” β€” β€” 1 8 BE47 Motor Vehicle Accidents 46 β€” β€” 2 2 11 3 3 1 8 6 10 BE48 All Other Accidents 51 1 1 β€” 1 2 5 5 5 5 6 20 BE49 Suicide and Self-inflicted Injuries 43 β€” β€” β€” β€” 7 4 5 9 11 6 1 BE49 All other external causes 6 β€” β€” β€” β€” 1 1 1 1 1 β€” 1 TOTAL ALL CAUSES 3,582 55 18 9 11 34 35 85 182 571 845 1,
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737 16 17 18 VITAL STATISTICS FOR THE PAST TWENTY YEARS (For the areas covered by the five constituent authorities) YEAR TOTAL LIVE BIRTHS BIRTH RATE (CRUDE) TOTAL INFANT DEATHS INFANTILE MORTALITY RATE 1951 4138 13.0 97 23.4 1952 4107 12.8 85 20.7 1953 4048 12.7 78 19.3 1954 4019 12.6 78 19.4 1955 4013 12.6 83 20.7 1956 4137 13.0 67 16.2 1957 4032 12.7 80 19.8 1958 4131 13.1 57 13.8 1959 4129 13.0 100 24.2 1960 4285 13.
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5 74 17.3 1961 4388 13.9 91 20.7 1962 4573 14.4 84 18.4 1963 4656 14.7 82 17.6 1964 4979 15.7 74 14.9 1965 4900 15.5 62 12.7 1966 4679 14.8 62 13.3 1967 4564 14.5 73 16.0 1968 4293 13.6 70 16.3 1969 4203 13.4 54 12.8 1970 4090 13.1 73 17.8 NUMBER OF DEATHS AND DEATH RATES FROM TUBERCULOSIS AND CANCER NUMBERS RATE PER 1,
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000 POPULATION MALES FEMALES PERSONS BARNET ENGLAND AND WALES Respiratory Tuberculosis 8 2 10 0.032 0.019 Other Tuberculosis 1 1 2 0.006 0.014 Cancer of lung and bronchus 162 54 216 0.690 0.617 Other Cancer 232 364 596 1.904 1.773 19 20 LIVE BIRTHS BY AGE AND PARITY OF MOTHER AND PLACE OF OCCURRENCE Parity of Mother * Place of Delivery Age of Mother All Ages Under 20 20 - 24 25 - 29 30 - 34 35 - 39 40 - 44 45 and over 0 1A 3 3 1B 1523 ( 0.2%) 144 - 721 ( 0.2%) 460 - 132 - 53 - 13 - - 2 62 (95.47.
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) 3 ( 9.0%) 30 (45.2%) 25 (28.8%) 3 ( 8.3%) 1 ( 3.3%) (0.8%) - 3 7 ( 3.9%) (0.2%) 6 ( 1.9%) 1 ( 1.6%) ( 0.2%) ( 0.1%) β€” - 4 2 ( 0.4%) - 1 ( 0.4%) ( 0.1%) 1 - β€” - - 1597 (0.1%) - ( 0.1%) β€” ( 0.1%) - - - 1 1A 1 1 1B 1105 ( 0.1%) 30 - 339 ( 0.1%) 468 - 189 - 69 - 13 - 1 - 2 44 (90.5%) ( 2.
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5%) 7 (27.8%) 24 (38.3%) 11 (15.1%) 1 ( 5.7%) 1 ( 1.1%) ( 0.1%) 3 69 ( 3.6%) 2 - 25 ( 0.6%) 29 ( 2.0%) 12 (0.9%) 1 ( 0.1%) ( 0.1%) - 4 2 ( 5.7%) ( 0.2%) ( 2.0%) ( 2.4%) 2 (1.0%) ( 0.1%) - β€” 1221 (0.2%) β€” β€” β€” ( 0.2%) β€” β€” β€” 2 1A 1B 490 - 1 - 65 - 194 - 144 - 73 - 13 - - 2 28 (85.4%) ( 0.2%) 1 (11.