C.439 a)ACTON ACT 48 Borough of Acton ANNUAL REPORT of the Medical Officer of Health together with the Report on the Medical Inspection of Schools FOR THE YEAR 1945 Borough of Acton ANNUAL REPORT of the Medical Officer of Health together with the Report on the Medical Inspection of Schools FOR THE YEAR 1945 ANNUAL REPORT of the MEDICAL OFFICER OF HEALTH FOR THE YEAR 1945 Public Health Department, Town Hall, Acton, W. 3. To the Mayor, Aldermen and Councillors of the Borough of Acton. Ladies and Gentlemen, We beg to submit the annual report on the health of the Borough for the year 1945. The Annual Report of the School Medical Service is given separately at the end. Dr. Payne, Medical Officer of Health, has been on active service during the whole of 1945, and this report on the work of his department has been compiled in his absence. 1945 saw the end of the war with the consequent winding up of all Civil Defence services, and the closure of all First Aid Posts and Ambulance Depots. The Civilian Ambulance Service which had been stationed at one of the Civil Defence Depots, was carried on in the same premises and, in the main, by the same people, until the end of the year. Details of the service are contained in the Annual Report. 4 Vital statistics show that the birth rate in Acton is about the same in 1945 as it was in 1944, being 18.5 as against 18.8. The Infant death rate is again satisfactorily low. In 1945 it was 40.4 as compared with 42.8 in 1944, and 46 for the whole of England and Wales. The Infantile Mortality Rate is said to be one of the most sensitive indices of the good social and hygienic conditions of an area. With Acton's at present overcrowded and distressing Housing conditions, for such a low figure to be reached is matter for satisfaction, but also for a determination to do better still. 64% of the deaths in infants under one year occurred during' the first month of life, and the majority of those during the first week. Congenital deformities and Prematurity accounted for nearly all those deaths, and these are the most difficult causes to prevent. Infectious disease numbers were low except for Measles. There was a country-wide epidemic of Measles which accounted for 519 cases of notified infectious disease out of a total of 844. The attendance figures for all Welfare Clinics have gone up and 85% of the mothers having babies in Acton attended the Borough's clinics for ante-natal advice during the year. All the work was heavier, necessitating the formation of an extra Health Visitor's district in September 1945, and the engagement of an extra full-time Health Visitor. The plan of having one Health Visitor detailed specially for ante-natal work, attending all clinics, visiting all pregnant women for survey of social and hygienic conditions, and to give advice; taking all ante-natal exercises, classes, etc., is working very successfully. The District Health Visitor who takes over when the baby arrives, finds the ground well prepared, the mother already knowledgeable as to what help she can get from the Borough's services, and willing to receive and to take advantage of the Health Visitor's expert knowledge. Classes for prospective fathers have been held on one or two occasions in the evenings, and have been appreciated and, we think, found helpful. Your Obedient Servants, G. E. B. PAYNE, E. MADELEY. 5 STAFF. George E. B. Payne, m.d., m.r.c.s., d.p.h., Medical Officer of Health and School Medical Officer. (On War Service). Elsie Madeley, m.b., ch.b., d.p.h., Acting Medical Officer of Health and School Medical Officer. Margaret Heller, m.d., Vienna, l.r.c.p., m.r.c.s. Edinburgh, Assistant Medical Officer of Health and Assistant School Medical Officer. P. H. Slater, l.d.s. School Dentist (Ret'd. from War Service 4.2.46). J. J. Matthews, m.r.s.i., Cert. of Royal Sanitary Institute, holds Meat and Smoke Certificates; Chief Sanitary Inspector (Inspector under Diseases of Animals Acts, Rag Flock Act, and Fabrics Misdescription Act). M. Dowie, m.r.s.i. Cert. of Royal Sanitary Institute, holds Meat Certificate; Deputy Chief Sanitary Inspector. G. W. Burdon Cert. of Royal Sanitary Institute, holds Meat Certificate; Sanitary Inspector. (Ret. from War Service 5.11.45). C. Codrington, Cert. of Royal Sanitary Institute, holds Meat Certificate; Temporary Sanitary Inspector. A. H. G. Johnson, m.r.s.i., Cert. of Royal Sanitary Institute, holds Meat Certificate; Meat Inspector. T. E. Parry, Cert. of Royal Sanitary Institute, holds Meat Certificate; Sanitary Inspector. D. G. Paterson, m.r.s.i., Cert. of Royal Sanitary Institute, holds Meat Certificate, Sanitary Inspector. Miss D. M. Beck, s.r.n., s.c.m. Cert. of Royal Sanitary Institute, Health Visitor and School Nurse. (Appointed 24.9.45). Miss N. Daniells, s.r.n., Certificate of Royal Sanitary Institute, s.c.m., Health Visitor and School Nurse. 6 Miss W. L. Orfeur, s.r.n., Certificate of Royal Sanitary Institute. s.c.m., Health Visitor and School Nurse. Miss M. Percival, s.r.n., Certificate of Royal Sanitary Institute, s.c.m., Health Visitor and School Nurse. Miss L. S. Pickering, s.r.n., Certificate of Royal Sanitary Institute, s.c.m., Health Visitor and School Nurse. Miss B. G. Sorlie, s.r.n., Certificate of Royal Sanitary Institute, s.c.m., Health Visitor and School Nurse Miss A. Woosnam, s.r.n., s.c.m., Health Visitor and School Nurse. A. S. M. Pratt, Barrister-at-Law; Chief Clerk. (Returned from War Service 21.1.46). Miss M. F. Willy, Senior Clerk. Miss K. M. Beer Clerk. Mrs. A. R. Ferguson, Clerk. Miss M. D. Goodger, Clerk. Miss M. G. Pears Clerk. Miss J. E. Thorp, Clerk. Miss H. Stone Matron, Bollo Bridge Road Day Nursery. Mrs. B. E. Bone Matron, Horn Lane Nursery. Mrs E. J. Hainstock Matron, Friars Place Lane Nursery. Mrs. M. Berry Matron, "Longcot," Newton Grove Nursery. SECTION A. General Statistics. Area 2,317 acres. Population Census 1931 70,510 „ Registrar General's Estimate 1945 57,200 Rateable Value at 31.12.45 £862,971 Sum represented by the product of a penny rate at 1.4.45 £3,450 General Rate in the £ 13/8d. 7 VITAL STATISTICS. (Comparable figures of 1944 given in brackets). Live Births: total males females Legitimate 946 (961) 489 (513) 457 (448) Illegitimate 94 (66) 44 (32) 50 (34) Totals 1040 (1027) 533 (545) 507 (482) Birth Rate per 1,000 estimated population is 18.5 (18.8). Still Births. total males females Legitimate 15 (27) 9 (16) 6 (11) Illegitimate 3 (1) 1 (-) 2 (1) Totals 18 (28) 10 (16) 8 (12) Deaths: 660 (727). Death Kate per 1,000 inhabitants 11.5 (13.3). Deaths from Puerperal Causes (Registrar General's short list for England and Wales, Headings 29 and 30): Rate per 1000 Deaths. Live & Still Births. No. '29. Puerperal Sepsis (-) (-) No. 30. Other Puerperal Causes 1 (-) .94 (-) Death Rate of Infants under 1 year of age. All infants pea 1000 live births (E. & W. 46) 40.4 (42.8) Legitimate infants per 1000 births 41.2 (41.6) Illegitimate infants per 1000 births 53.2 (60.6) Deaths from Cancer (all ages) 119 (117) Deaths from Measles (all ages) (1) Deaths from Whooping Cough (all ages) (-) Deaths from Diphtheria (all ages) (-) Deaths from Diarrhoea (under 2 years of age) 4 (12) Death Rate from Diarrhoea (under 2 years of age) 3.84* (*England and Wales 5.6). AGES AT DEATH, AND WARD DISTRIBUTION OF DEATHS IN 1945. Causes of Death Total —1 1—2 2—5 5—15 15—25 25—45 45—65 65 + Ward Distribution. N.E. N.W. S.E. S.W. Diseases of bones & organs of movt 3 1 - - - - - 1 1 2 - - 1 Bronchitis 34 2 - — 1 — — 11 20 11 7 3 13 Cerebro-spinal meningitis 3 — 2 1 — — — — — — — 1 2 Cancer 119 - - - - - 9 39 71 38 36 17 28 Cerebral Haemorrhage & Thrombosis 68 1 — — — — 3 13 51 14 24 13 17 Childbirth—Disease of Pregnancy & Puerperium 1 - - - - - 1 - - - - 1 — Circulatory Diseases 46 — 1 — — — 1 7 37 13 11 7 15 Cirrhosis of Liver 1 — — — — — — 1 — — 1 — — Congenital Debility and Prematurity 25 24 — 1 - - - - - 7 10 — 8 Diphtheria — — — — — — - — — — — — — Diabetes 1 - - - - - - - 1 — — 1 — Digestive Tract Diseases 12 1 — — — 1 2 2 6 — 7 2 3 Gastro-Enteritis 5 4 — — — — 1 — — 1 2 — 2 Gall Bladder Diseases 2 - - - - - - - 2 — 1 — 1 Heart Disease 130 — — — 1 1 4 37 87 33 36 22 39 Infective and parasitic Diseases — — — — - — — — — — — — — Influenza - - - - - - - - - - - - — Liver Disease (not Cirrhosis) 1 - - - - - -1 - - - - 1 Leukaemia and Anaemia (Blood and Blood forming tissue Diseases) 9 - - - 1 - - 3 5 4 3 2 — Measles — — — — — — - — — — — — — Meningitis (not C.S.M. or T.B.) 3 1 — — — — — 2 — 1 — — 2 Carried forward 463 34 3 2 3 2 21 117 281 124 138 69 132 8 AGES AT DEATH, AND WARD DISTRIBUTION OF DEATHS IN 1945—continued. Causes of Death Total —1 1—2 2—5 5—15 15—25 25—45 45—65 65 + Ward Distribution*. N.E. N.W. S.E. S.W. Brought forward 463 34 3 2 3 2 21 117 281 124 138 69 132 Nervous System & Diseases of Sense Organs 5 - - - - - 2 1 2 1 1 3 - Nephritis 12 — — — — 1 1 6 4 9 1 — 2 Parturition Disease (other than Childbirth and Puerperal Pyrexia) 1 - - - - - 1 - - 1 - - - Peptic Ulcer 3 — — — — — — 1 2 1 1 — 1 Pneumonia 40 6 — — — — 4 12 24 18 13 7 8 Prostate Enlargement 4 — — — — — — 1 3 1 2 1 — Puerperal Pyrexia — — — — — — — — — — — — — Pulmonary Tuberculosis 41 — — — — 7 14 15 5 14 9 7 11 Respiratory Diseases 13 1 — — — — 4 3 5 3 3 2 5 Rheumatism—Diseases of Nutrition, Vitamin Deficiencies 5 1 - - 1 - - 2 1 1 2 - 2 Sarcoma 2 — — — — — — 2 - 1 - 1 - Scarlet Fever — — — — — — — - - — - — - Senility 43 — — — — — — — 43 20 7 6 10 Suicide 6 — —. — — — 3 2 1 3 2 — 1 Tuberculosis (other than Pulmonary Tuberculosis) 4 - - 1 - - 3 - - 1 1 1 1 Undefined Diseases 2 — — — — — 1 — 1 - 2 — — Violent Deaths 9 — — 1 1 - — 4 3 3 3 - 3 Whooping Cough — — — — — — — — — — — — — War Deaths 1 — — — — — — 1 — — — 1 — TOTALS 660 42 3 4 5 10 54 167 375 201 185 98 176 9 10 1945—Cause of Death in Children under one year: 27 Males. 15 Females. Under 1 wk. 1—2 wks. 2—3 wks. 3—4 wks. Total under 1 month. 1—3 mths. 3—6 mths. 6—9 mths. 9—12 mths. Total 1—12 months. Atelactasis 4 - - - 4 - - - - - Bronchitis — - - - — 1 - 1 — 2 Bronchopneumonia — - - 1 1 1 1 1 — 3 Bronchopneumonia & Gastro Enteritis - - - - - - - 1 1 2 Congenital Defects 2 2 1 - 5 — 1 — — 1 Gastro Enteritis — — - - — 2 - 1 — 3 Intercranial Haemorrhage & Thrombosis 1 - - - 1 - - - - - Prematurity 7 4 - - 11 - - - - - Marasmus — — - - — 1 - — — 1 Meningitis - - - - - - - 1 — 1 Pleural Effusion — — - - — 1 - — — 1 Osteomyelitis — 1 - - 1 — - — - — Haemorrhagic Disease of the Newly Born 1 - - - 1 - - - - - Asphyxia Neonatorum 2 - - - 2 - - - - - Intestinal Obstruction — 1 — — 1 — — 1 — 1 Total 17 8 1 1 27 6 2 6 1 15 40.5% died during first week of life. 64.3% died during first month of life. Percentage of deaths Percentage of total Percentage of deaths under one year. deaths under 45. taking place in Hospital. 6.4 18.1 52.7 Comparative figures of Infant Mortality in last five years. Acton. England and Wales. 1941 47.8 59 1942 71.2 49 1943 62.4 49 1944 42.8 46 1945 40.4 46 11 Maternal Mortality. There was one maternal death during the year. Inquests. Suicide 7 Accidental Fall 9 Motor car, train and tram accidents 4 Other causes 12 Total 32 Post Mortems without inquest. Heart Disease 28 Respiratory conditions 33 Rupture of Organ or Tissue 25 Other causes 43 Total 129 SECTION B. General Provision of Health Services in the Area. Laboratory Facilities. As in 1944, all materials requiring bacteriological examination were sent to the Emergency Medical Service Laboratory at St. Mary's, Paddington. Ambulance Facilities. For the first six months of the year, the Ambulance Service was manned by Civil Defence personnel, seven men and one woman telephonist on each of two watches working a 24 hour shift. After the stand-down of Civil Defence the service continued at the same strength until its quarters were moved to the Fire Station, Gunnersbury Lane, when it became possible to reduce its establishment to five men and one officer to each watch. 12 Three ambulances were available throughout the year, and in November the purchase of a new vehicle allowed the disposal of the oldest, so that three ambulances continued in use at the end of the period. During the year, 1,564 cases of all kinds, (including 183 maternity cases) were carried a total distance of 9,040 miles. The Acton and Wembley Joint Hospital Board continued to maintain an ambulance for removal of infectious cases. Nursing in the Home. The same facilities exist as in previous years, the number of sick persons under care was 428, necessitating 14,388 visits. Hospital Provision. The Acton Borough Council together with the Wembley Borough Council maintain a Joint Hospital for treatment of infectious cases. The Acton Voluntary Hospital treats both surgical and medical cases, as does the Central Middlesex County Hospital, which is maintained by the Middlesex County Council. MATERNITY AND CHILD WELFARE. Four Centres were open all the year for Infant Welfare Clinics:— (1) At the School Clinic, Avenue Road (two, and then three Health Visitor's districts served by this Centre). (2) At Rothschild Road School (Steele Road Mission Hall from 10.12.45). (3) John Perryn School. (4) St. Gabriel's Church Hall, Noel Road. Two weekly sessions were held for each Health Visitor's district, one with a doctor in attendance, and one without, until after the appointment of an additional Health Visitor in September 1945, when two of the Health Visitors and their districts had to share sessions and a doctor was in attendance at each. 13 Average weekly attendances (last year's figures in brackets): Central district 66.8 (54.2) South East 73 (58) South West 79.6 (63) North East 76 (52.5) North West 73.7 (50.4) During some part of the year the arrangement whereby representatives from the Food Office attended for the sale of cod liver oil and fruit juices, broke down and all mothers had to go to the Food Office for their vitamin preparations. This was owing to shortage of staff at the Food Office and the former arrangement of selling at each Welfare Centre is to be resumed as soon as possible. Attached is a Table showing the attendances at all Clinics and the visits paid by the Health Visitors to the homes. The numbers of mothers and children seen and treated at the Ophthalmic and Dental Clinics are given in the School Medical Report. Health Visiting. Number of visits paid during the year by all Health Visitors working in this area: To expectant mothers First Visits 615 Total Visits 1236 To children under one year of age First Visits 985 Total Visits 3707 To children between the ages of one Total Visits 3888 and five. Infant Welfare Centres. Total number of children who first attended the Centres during the year, and who, on the date of their first attendance, were: — Under one year of age 975 Between the ages of one and five 120 Total number of children under 5 years of age who attended at the Centres during the year and who, at the end of the year were:— Under one year of age 798 Over one year 1584 14 Total number of attendances at Centres during the year:— (a) By children under one year of age 13151 (b) By children between one and five years 6061 A total of 743 Toddlers attended the Welfare Centres during 1945, for a yearly examination. Midwifery Service. Domiciliary Midwifery was performed as in previous years by Queen Charlotte's Midwives. During 1945, 449 mothers were recommended for admission to Central Middlesex County Hospital for their confinements, but of these 84 had to be refused as there were no beds. The continued rise in the birth rate all over the country is straining the resources of hospital beds and trained midwives to the uttermost. Many of the Emergency Hostels and Homes for Expectant Mothers in former "reception" areas have closed down, and owing to the desperate housing position in London and Greater London, many more women require hospital accommodation for their confinements. Three ante-natal clinics were held each week, but towards the end of the year it became increasingly obvious that it would be necessary to open a fourth. Number of new cases attending Clinics during year 900 Total number of attendances made 3285 Average number attending weekly (3 clinics) 67 The following Table gives the stage of pregnancy at which the new cases reported for examination: 1st month 40 2nd „ 193 3rd „ 267 4th „ 177 5th „ 119 6th „ 53 7th „ 29 8th „ 16 15 54.4% came for examination when 1—3 months pregnant. 70.9% came for examination when 1—4 months pregnant. 85.2% of mothers whose confinements were notified attended the ante-natal clinics in the Borough, the great majority being referred either to Queen Charlotte's Hospital or Central Middlesex County Hospital, at the 36th week of pregnancy. 6 patients who attended were found not to be pregnant. The arrangements made by women for their confinements are tabulated below: Confined in Central Middlesex County Hospital 42.5% „ Queen Charlotte's Hospital 16.7% „ „ other Hospitals 4.2% „ „ Nursing Homes 6.5% „ at home (Queen Charlotte's Midwives attending) 26.4% Evacuated to Emergency Maternity Hostels 3.7% Evacuation of expectant mothers took place as follows: January 11 July 2 February 2 August 2 March 3 September 3 April 2 October - May 3 November 4 June 4 December 1 Total 37. Post Natal Clinics. The number seen was small as the majority of women had their post natal examination at the hospital where they were confined, and those confined at home were examined by Queen Charlotte's Hospital. Only those not examined before return from evacuation required arrangements to be made for them. Food Sales. During the year the Maternity and Child Welfare Centres supplied the following quantities of milk foods: For sale 21,593 lbs. Free 93 lbs. 16 The Food Executive Officer has kindly supplied the following figures of milk and vitamin preparations issued by his department to expectant and nursing mothers and to children: Orange juice 54,661 bottles (43,849 last year). Cod Liver Oil 7,197 „ (6,440 „ „). Vitamin Capsules 2,117 pckts. (1,756 „ „). National Dried Milk 11,374 tins (6,762 „ „). Birth Control Clinics. Previous arrangements for this purpose with the North Kensington Women's Welfare Centre were continued, and 22 patients were sent there for advice in 1945. Sterility Clinic. During the year, 2 patients were referred to this clinic at North Kensington Women's Welfare Centre, arrangements for that purpose having been made in 1944. Exercise Class for Mothers. This class for ante natal exercises is held in the hut behind the School Clinic and is becomingi ncreasingly popular. The number of mothers who attended during the year was 73 and the total number of attendances made was 508. Home Help Scheme. At the end of the year there were 2 full time Home Helps and 2 part time. The following Table shows the number of cases booked and those actually attended: Number of cases bookedA 67 Number of cases attended 54 Number of cases cancelled 13 Domestic Help Scheme. Circular 179/44 of the Ministry of Health was received in December 1944. This circular advocated the setting up of a Domestic 17 Help Service by Local Authorities. Women were to be employed, either whole time or part time, to help the old and sick who were unable to obtain domestic service at a figure which they could afford. This scheme was adopted by the Borough Council, and in January 1945 the first Domestic Help was engaged on a part time basis. Gradually a small staff was built up until by December 1945 there were 3 full time Domestic Helps and 2 part time. It was not easy to get suitable persons and, as always happens with such a service, the work came in rushes. At times the staff would be overwhelmed with calls, while at other times they were comparatively free. 58 cases were attended during the year. 6 who made application, later cancelled the arrangements. Day Nurseries. War-time Nurseries. Opened. Places. Horn Lane 30.3.42. 60 Friars Place Lane 4.8.42. 45 Longcot 15.10.42. 44 Birkbeck Road: (a) Birkbeck House for under 2's 11.1.43. 30 (b) Maples House for over 2's 22.2.43. 46 Municipal Day Nursery, Bollo Br. Rd. Pre-War 35 During the first three months of 1945, there was an epidemic of Measles in all the Nurseries (in common with the rest of the country) and attendances dropped very much. No new admissions are made to a Nursery while it is in quarantine for Measles, unless the child has had the disease and the mother accepts full responsibility for the child's admission, all risks having been explained to her. Contrary to expectations, the end of the war brought no slackening in demand for places at the Day Nurseries. There was still obviously a local need for women in industry, thereby creating the continued necessity for Day Nurseries to care for their children. The following Table gives the average daily attendances at the War-Time Nurseries: Under 2. Over 2. Horn Lane 13.1 25.6 Friars Place Lane 10.9 25.8 Longcot 13.7 20.1 Birkbeck Rd. & The Maples 20.2 36.5 18 Infectious Diseases. 845 cases of notifiable disease occurred in the Borough, last year's figures being 318. The increase is attributable to a Measles epidemic, there being 519 cases of Measles. There were only 10 cases of Diphtheria, 25 cases of Whooping Cough, and 65 cases of Scarlet Fever. There were no deaths from Diphtheria, Scarlet Fever, Measles or Whooping Cough in 1945. 48 cases of Pneumonia were notified during the year, as against 65 in 1944. Diphtheria Immunisation. Immunisation was practised with unabated vigour throughout the year. Advertisements were placed monthly in the local paper, giving times and places for Inoculation Clinics, and posters were displayed in prominent places. In addition, all our previous ways of contacting parents were continued: (1) A notice was sent to the parent of each notified birth when the child attained the age of 6 months. (2) All Infant Welfare attenders were approached. (3) All children admitted to Day Nurseries were offered protection. (4) Health Visitors combed their districts for children who did not attend Welfares and urged their protection. (5) Head Teachers gave forms of consent to new entrants. (6) Prior to school medical inspection sessions, questionnaires were sent to each parent asking, inter alia, whether the child had been inoculated. If the answer were in the negative, a form of consent was sent to the parent. All immunised cases are followed up and, at the end of three years, each child is offered a boost dose. After the age of 11 years, this is preceded by a Schick test. All children under 5 who have not had the disease, are inoculated against Whooping Cough at the same time as they are inoculated against Diphtheria, i.e., they have three doses of protective material at monthly intervals. There were only 25 notified cases of Whooping Cough and 10 cases of Diphtheria in 1945, which is very little for a Borough with a population figure for children under 14 of 10,610. 19 Two of the 10 cases of Diphtheria had been immunised. One of these cases was very mild, but the second had a sharp attack and, but for having been inoculated, might have died. Both were school children. One case was a carrier and an adult, the remaining 7 were school children and had not been immunised. 7 of the 9 children attacked, attended Berrymede School, one attended Priory, and one the Central School, but both lived in South Acton. It is precisely in this area that our percentage of immunised child population is lowest and where we find it most difficult to obtain consent for inoculation. 8 families only were affected, two brothers in one family, and two sisters in another becoming infected at the same time. 45% of the population under 5 years of age is now protected, and 61.5% of the population aged 5 to 14. These figures are still not good enough and no effort will be spared to improve them. Diphtheria Immunisations, 1945. Total number of under 5's inoculated 914 Total number of over 5's inoculated 155 Re-inoculations after 3 years 483 Schick tests after 3 years—negative 182 positive 54 Primary Schick tests negative 45 positive 64 CASES OF INFECTIOUS DISEASE NOTIFIED DURING THE YEAR 1945. Notifiable Disease. Cases notified in whole District. At Ages—Years. Ward Distribution. At all Ages Under 1 1 to 5 5 to 15 15 to 25 25 to 45 45 to 65 Over 65 North East North West South East South West Scarlet Fever 65 - 12 46 4 2 1 - 12 21 6 26 Diphtheria 10 — 1 8 1 1 — — — 2 — 8 Pneumonia 48 - 3 2 2 14 17 10 17 19 5 7 Erysipelas 7 — — — — 3 4 — 1 2 2 2 Puerperal Pyrexia 3 - - - - 2 1 - - 1 1 1 Dysentery 28 - 13 10 2 2 1 — 10 10 2 6 Tuberculosis (resp.) 110 — 1 3 38 38 26 4 42 30 16 22 Tuberculosis (non-resp.) 18 — 1 3 6 6 2 — 4 5 4 5 Measles 519 18 295 187 15 4 — — 167 118 104 130 Whooping Cough 25 4 12 9 — — — — 8 10 3 4 Ophthalmia Neonatorum 4 4 - - - - - - 1 2 — 1 Meningitis 1 — — 1 — — — — — — 1 — Typhoid - - - - - - - - - - - - Food Poisoning 3 — — — — 1 1 1 3 — — — Poliomyelitis 3 1 2 - - - - - - - 1 2 TOTALS 844 27 340 269 68 73 53 15 265 220 145 214 20 21 Acton and Wembley Joint Hospital Report for the Year 1945. Patients admitted during 1944 395 Patients admitted during 1945 354 ADMISSIONS : S. F. Diph. C.S.M. Ery. C.Pox Measles Wh.C. Acton 60 20 8 1 1 26 3 Wembley 113 11 6 6 2 33 6 173 31 14 10 3 59 9 Dvs. Mumps Enteritis D.&V. Impetigo Typhoid Paratyphoid Total Acton 24 1 2 — 5 — — 154 Wembley 11 2 1 4 — 2 3 200 35 3 3 4 5 2 3 354 TOTAL 354. DEATHS: C.S.M. Wh.C. Dysentery Ery. *GastroEnteritis Acton 1 — — — 1 Wembley — 1 1 1 — 1 1 1 1 1 TOTAL 5. *(admitted with Whooping Cough). DISCHARGES: S.F. Diph. C.S.M. Ery. C.P. Measles Wh.C. Dys. Acton 53 19 7 4 1 29 2 26 Wembley 104 12 4 5 2 39 4 10 157 31 11 9 3 68 6 36 Mumps Enteritis D.&V. C.S.F. Typhoid Impt. Para typhoid Total Acton 1 2 — — — 5 — 149 Wembley 2 1 4 2 2 — 3 194 3 3 4 2 2 5 3 343 TOTAL 343. Patients in hospital January 1st, 1945 28 Patients in hospital January 1st, 1946 34 22 Tuberculosis. Particulars of new cases and of deaths from the disease during 1945 are given below: 110 new cases of Pulmonary Tuberculosis and 18 cases of NonPulmonary Tuberculosis occurred during the year. There were 41 deaths from Pulmonary and 4 deaths from Non-Pulmonary Tuberculosis during the year. The tables following give the age incidence of new cases of the disease in 1945 and of deaths from the same cause: NEW CASES. DEATHS. At Ages Resp. Non-Resp. Resp. Non- Resp. M. F. M. F. M. F. M. F. 0—1 - - - - - - - 1 1—5 — 1 — 1 — — — — 5—15 2 1 1 2 — — — — 15—25 17 21 2 4 3 4 — 1 25—35 12 13 3 — 8 2 1 — 35—45 9 4 1 2 4 — 1 — 45—55 13 3 1 — 6 3 — — 55—65 7 3 1 — 5 1 — — 65 + 3 1 — — 4 1 — — 63 47 9 9 30 11 2 2 23 Statement of particulars appearing on the Register of cases of Tuberculosis for the year 1945. Pulmonary NonPulmonary Total (a) Number of Cases of T.B. on the Register at the commencement of Year 364 males 276 females 59 males 70 females 769 (b) Number of Cases notified for the first time during the Year 55 males 36 females 8 males 8 females 107 (c) Number of Cases previously removed from the Register which have been restored thereto during the year 3 males 1 female males females 4 (d) Number of Cases added to the Register other than by notification 13 males 16 females 2 males 3 females 34 (e) Number of Cases removed from the Register during the Year 47 males 27 females 5 males 4 females 83 (f) Number of Cases remainon the Register at the end of the Year 388 males 302 females 64 males 77 females 831 Scabies and Verminous Conditions. As in previous years, cases for the above conditions have been referred to Kensington Medicinal Baths for cleansing treatment. This year, as will be seen in the tables below, the number of cases and the number of families referred for Scabies is appreciably less than the year before. The number of families is a more significant figure than the number of cases as it is always our endeavour to have a whole family treated even if only one member is obviously affected. 24 PATIENTS TREATED AT KENSINGTON BATHS FOR SCABIES—1945. Month. Total. N.E. N.W. S.E. N.W. Ref. by Factory. No. of families treated. January 30 8 9 1 12 — 15 February 24 8 1 2 12 1 13 March 26 11 7 — 6 2 14 April 24 13 — 8 3 — 10 May 27 — 14 — 13 — 13 June 27 8 1 1 12 5 10 July 22 11 1 — 10 — 7 August 50 10 7 10 23 — 25 September 54 9 17 5 17 6 19 October 33 17 7 4 5 — 17 November 22 9 8 2 3 — 13 December 19 6 1 — 12 — 8 TOTAL 358 110 73 33 128 14 164 PATIENTS TREATED AT KENSINGTON BATHS FOR VERMINOUS HEADS DURING 1945. Month. Total. N.E. N.W. S.E. S.W. Ref. by Factory. No. of families treated. January 10 7 — — 3 — 4 February 9 1 2 — 6 — 7 March 11 5 3 1 1 1 7 April 3 — 2 — 1 — 2 May 8 5 2 — 1 — 4 June 1 — — — 1 — 1 July 10 — 1 — 9 — 7 August 9 7 — 2 — — 5 September 12 3 5 — 4 — 8 October 6 — 1 — 5 — 3 November 3 — 1 1 1 — 3 December 9 — — 1 8 — 7 TOTAL 91 28 17 5 40 1 58 PREMATURE INFANTS. Total number notified : 61. Born at Home: 10 Born in Hospital: 51 Nursed entirely at Home. Died in 24 hours. Survived 1 month. Died in 24 hours. Died between 1 day and 1 month. Survived 1 month. 10 3 7 3 9 39 25 Care of Illegitimate Children. During 1945, only one mother was sent to the Hostel under the arrangements made with the County Council. SECTION C. SANITARY CIRCUMSTANCES OF THE AREA. Water Supply. The Borough is supplied with water by the Metropolitan Water Board. The supply has been satisfactory and the whole of the population is supplied from the public water mains direct to each house. Drainage and Sewerage. All the dwelling houses are provided with water closets and are drained into the main sewerage system. By arrangement with the London County Council the sewage is discharged into the London sewers. Storm water is filtered and emptied into the Thames. Public Cleansing. The amount of house refuse collected by the Council in 1945 was 13,163 tons, of which 1,860 was salvage. Trade refuse collected amounted to 1,441 tons, and a total weight of 12,744 tons was burned by Destructor. Rodent Control. Work of rats and mice disinfestation has been intensified, particular attention having been paid to every complaint as to the presence of rats at or in the vicinity of any premises, and the immediate treatment and consequent destruction of the rodents has prevented serious infestation. The policy of maintained treatment at business premises, especially in food factories and warehouses, is being pursued with the hearty co—operation of the occupiers, and there is no doubt as to the value of this work as reflected in the saving of foodstuffs, materials and structures. The general work has entailed a total of 1,084 visits, 703 to business premises and 381 to dwelling houses, in addition to inspections by the Sanitary Inspectors as noted elsewhere. 26 Sanitary Inspection of the Area. The following Table includes the tabular statement furnished by the Chief Sanitary Inspector under Article 27 (18) of the Sanitary Officers (Outside London) Regulations, 1935. Tabular Statement of Inspections and Detail of Work Carried Out by Sanitary Inspectors. Number of Inspections made and Action Taken: Total number of dwelling houses inspected for housing defects (under Public Health or Housing Acts) 3,001 (1) Dealt with by service of Informal Notice 1,670 (2) Dealt with by service of Statutory Notice under Section 9, Housing Act, 1936 314 (3) Dealt with by service of Statutory Notice under Public Health Acts 91 (4) No defects found 111 Premises (other than defective dwelling—houses) inspected for nuisances and miscellaneous defects 1,890 (1) Dealt with by service of Informal Notice 189 (2) Dealt with by service of Statutory Notice under Public Health Act, etc. 1 Re—inspections subsequent to service of Notice 10,359 Inspections after notification of Infectious Disease 161 Premises inspected under Rats and Mice (Destruction) Act, 1919, and Infestation Order, 1943 644 Details of work carried out: The following details of work carried out indicates the need for extensive repairs to dwelling houses. The prevalence of dry rot in house timbers—largely a legacy of wartime conditions—occasioned much time and labour for the Sanitary Inspectors in securing the information necessary for the granting of certificates of essentiality and building licences, in addition to the general estimating of the cost of works in every case where service of notice upon the owner was necessary. In this connection, four of the Sanitary Inspectors 27 voluntarily took a three months' course of estimating, and the knowledge gained facilitated this special work, normally outside the Inspector's sphere. Sanitary dustbins provided 374 Yards paved or yard paving repaired 14 Insanitary forecourts remedied 4 Defective drains repaired or reconstructed 102 Defective soil pipes and ventilating shafts repaired or renewed 32 Defective fresh air inlets repaired or renewed 11 Defective gullies removed and replaced by new 29 Rain water downpipes disconnected from drain 4 Dishing and curb to gullies repaired and new gratings fixed 20 Defective W.C. pans and traps removed and replaced by new 95 Defective W.C. flushing apparatus repaired or new fixed 122 Defective W.C. seats repaired or new fixed 56 Defective flush pipe connections repaired 29 Insanitary sinks removed or new fixed 21 Sink waste pipes repaired or trapped 113 Insanitary wall surface over sinks remedied 51 Ventilated food cupboards provided 6 Drinking water cisterns cleansed 9 Defective covers to drinking water cisterns repaired or new fixed 31 Insanitary sites beneath floors concreted 6 Spaces beneath floors ventilated 25 Dampness in walls from defective damp—proof course remedied 221 Dampness from defective roof, rainwater gutterings, etc., remedied 1,359 Defective plastering repaired (number of rooms) 1,458 Rooms where dirty walls and ceilings have been cleansed and redecorated 1,412 Defective floors repaired 356 Defective or dangerous stairs repaired 49 Defective doors and windows repaired 1,244 Defective kitchen ranges and fire grates repaired 367 Defective washing coppers repaired 17 Coal cupboards provided or repaired 4 Accumulations of offensive matter removed 33 Drains unstopped and cleansed 211 Drains tested, exposed for examination, etc. 221 Smoke observations taken 22 Smoke nuisances abated on service of notice 4 Miscellaneous nuisances abated 166 Notification of waste of water sent to Metropolitan Water Board 269 28 RENT RESTRICTION ACT. Certificates granted to occupier 8 Certificates (clearance) granted to owners 4 PREMISES UNDER PERIODICAL INSPECTION. Factories and Workshops 601 Piggeries 4 Rag Dealers 2 Mews 4 Public House Urinals 31 Hairdressers 43 School Buildings: Elementary 11, Secondary 2, Technical 2, Special (M.D.) 1, Private 3 19 Butchers' Shops 37 Fish Shops 29 Fish and Chip Shops 14 Greengrocers' Shops 56 Premises where food is manufactured* or prepared 43 Grocery and Provision Shops 161 Dairies 14 Bakehouses 26 Slaughterhouses 2 Restaurants, Cafes, etc. 140 Premises where ice—cream is manufactured 13 Food Inspection. Upwards of 30,600 tins of meat, fish, fruit, milk, etc., and a quantity of raw and preserved food of various kinds were surrendered as unfit for human food. In addition, large quantities of meat, fish and milk out of condition and not suitable for retail distribution were received into the Borough for manufacturing purposes, and the whole of these foodstuffs received special and detailed attention from the Sanitary Inspectors. Approval for manufacturing purposes was given as appropriate, particularly with regard to meat and milk, and salvage where possible was arranged by way of animal feeding so far as canned fish, vegetables, etc., were concerned. The total number of cans referred to were made up largely of condensed milk collected from various retail premises in other districts and returned to a warehouse within the borough. 29 Milk. The fourteen dairies within the borough have been regularly inspected and have been maintained in a hygienic condition, and in no case has there been any complaint as to the milk distributed therefrom. During the year, practical reconstruction of the dairy, installation of new pasteurising plant and renewal of bottle—washing and filling machinery were completed at the milk bottling depot in Bollo Lane. Inspection of the premises and plant and the results of sampling from time to time of the processed milk have shown a very high degree of efficiency in the dairy, and no complaint has been received with respect to any milk or bottle distributed therefrom. Much attention has been devoted to the inspection of milk bottles, with a view to ensuring the distribution of a clean and wholesome milk supply. A number of complaints were received as to the presence of foreign matter in milk in bottles and as to dirty bottles containing milk, delivered from dairies outside the Borough, and these were reported to the Public Health Committee, when appropriate action was authorised. In the cases of two bottles of milk the firm who sold the milk in dirty bottles were prosecuted under the Food and Drags Act, 1938, for having sold milk unfit for human food, and fines of £25 and costs were imposed on the firm in respect of each sale. Six samples of milk were taken from premises or roundsmen in the borough, and on submission to bacteriological examination all were found to be satisfactory samples. Including the regular sampling of pasteurised milk at the bottling depot in Bollo Lane, 146 samples have been taken from premises and roundsmen, and on submission to the prescribed Phosphatase Test, in each case the milk was proved to have been properly pasteurised. Water. Five samples of water were taken and submitted for examination, three as to bacteriological and two as to chemical content, and in every case the result showed the sample to be satisfactory. Diseases of Animals. In the course of the year there occurred outside the borough four outbreaks of Foot and Mouth Disease, in respect of which Acton was included in the Schedules of Infected Areas, and 741 licences were granted by this Local Authority for the removal of pigs into the borough for slaughter. In a number of cases, 30 persons to whom licences were granted, failed to observe the conditions of the licences when completing movement of animals, and thus control was lost. The licensees were communicated with, the offences pointed out to them, and explanations called for, and these were duly submitted to the Animal Health Division of the Ministry of Agriculture and Fisheries as requested, following which an intimation was received from the Secretary that no further action need be taken in the matter. Slaughterhouses. The slaughterhouses at Atlas Road and Hanbury Road have been in commission throughout the year, and the carcase and offal of every animal slaughtered have been examined as to their fitness for human food. The number of animals slaughtered is 74,606 pigs and 3,838 horses. The large increase in the number of horses slaughtered appears to indicate the growing popularity of horseflesh for human consumption. Tables showing details of meat and offal surrendered following examination by the Sanitary Inspectors will be. found on the two succeeding pages. TOTAL NUMBER OF ALL CARCASES INSPECTED DURING 1945, WITH DETAILS OF SURRENDER ON ACCOUNT OF DISEASE. Pigs. Horses. 1. Number killed 74,606 3,838 2. Number inspected 74,606 3,838 3. All diseases except Tuberculosis:— Whole carcases condemned 68 10 Carcases of which some part or organ was condemned 984 738 Percentage of the number inspected affected with disease other than Tuberculosis 1.4% 19.43% 4. Tuberculosis Only:— Whole carcases condemned 58 — Carcases of which some part or Organ was condemned 2,095 — Percentage of number inspected affected with Tuberculosis 2..88% — 31 NUMBER OF PIGS' CARCASES INSPECTED DURING 1945 WITH ANALYSIS OF SURRENDERS ON ACCOUNT OF DISEASE. Date Pigs Slaughtered PARTS CONDEMNED. Carcases Heads Collars Fore Qtrs. Hind Qtrs. Legs Plucks (Lungs, Livers, Hearts) Wt. of Mesenteries, Stomachs & Intestines Pieces of of Pork Skins Hocks January 7167 31 98 1 — — 20 105 142 lbs. — lbs. 3 — February 5772 8 87 — — — 20 96 64 lbs. 2 lbs. — 2 March 5604 10 82 — 2 — 16 95 103 lbs. 2 lbs. 2 3 April 5708 7 80 — — — 14 108 70 lbs. 10 lbs. 6 1 May 6023 7 95 — 6 — 16 82 62 lbs. — lbs. 5 1 June 6264 9 128 1 — — 6 82 40 lbs. — lbs. 5 1 July 7004 9 130 — 2 — 17 119 144 lbs. 31 lbs. 7 1 August 6479 9 128 — 1 — 18 127 72 lbs. 31 lbs. 1 1 September 6532 1 125 — 3 — 21 91 47 lbs. 55 lbs. 5 2 October 7326 15 136 — 2 — 25 116 38 lbs. 15 lbs. 7 3 November 5780 7 104 — 4 — 29 104 74 lbs. 6 lbs. 3 2 December 4947 3 120 — — — 35 133 285 lbs. 38 lbs. 2 1 Total 74606 116 1313 2 20 — 237 1258 1141 lbs. 190 lbs. 46 18 33 ANNUAL REPORT of the School Medical Officer FOR THE YEAR 1945. Ladies and Gentlemen, We beg to submit the following report upon the schools and the school children of Acton for the year 1945. 1945 was a very busy year during which the new Education Act came into force. One of the results of this may be seen in the figures of defects treated at the Minor Ailment Clinics. The figure for 1944 was 966 whereas in 1945 it rose to 4221. If 1944 is compared with 1945, it will be seen that all the figures in 1945 are higher and in the Dental Clinics the number treated has almost doubled. All this increase of work has been done in the same inadequate and out—of—date premises at 45, Avenue Road. The pressure of space was so great that the hut in the garden, formerly in use as a School Dinner Centre, had to be renovated and brought into use. The Dental Staff will be helped by the expected return of Mr. P. H. Slater, School Dentist, from the Forces early in 1946. The appointment of an additional Health Visitor and School Nurse in September helped a little and the return of Miss J. M. Watts from the Forces early in 1946 will help the clerical staff to deal with the vastly increased records. All Clinics were open during the year and figures for each are given in the Report. At the end of the year the number of children on the roll was 5,592 and 10 Nursery Classes were open during the year. There was an epidemic of Measles during the year, 227 cases being reported from the schools. There were only 8 cases of 34 Diphtheria amongst school children and inoculation sessions were held, as formerly, once a week at the School Clinic. A description of how the Inoculation Scheme is worked will be found in the Public Health section of the Medical Officer of Health's report. Your obedient Servants, G. E. PAYNE, E. M. MADELEY. SCHOOL MEALS AND MILK. Number of meals supplied—1945 402,600 Number of free meals supplied:— 32,213 Ordinary Schools 31,354 Special Schools 859 Number of bottles of free milk supplied:— 70,935 Ordinary Schools 69,264 Special Schools 1,671 INFECTIOUS DISEASES. Scarlet Fever. 43 cases of Scarlet Fever were reported during 1945 in the school population, the distribution being as follows:— Acton Wells 1 Beaumont Park 2 Berrymede 10 Catholic School 1 Derwentwater 7 John Perryn 5 Priory 5 Rothschild 4 Southfield 4 West Acton 4 35 Diphtheria. 8 cases of Diphtheria were reported in 1945 in the schools, the distribution being as follows:— Acton Central 1 Berrymede 6 Priory 1 Percentages of Children Inoculated in School. Acton Wells Secondary 67.69 Acton Wells Lower 60.74 Beaumont Park 63.21 Berrymede Boys' 53.57 Berrymede Girls' 54.54 Berrymede Infants' 57.53 Acton Central Secondary 68.23 Derwentwater Junior 58.20 Derwentwater Infants' 64.28 John Perryn Upper 56.79 John Perryn Lower 71.21 Priory Boys' Secondary 46.34 Priory Girls' Secondary 55.10 Priory Infants,' 62.96 Rothschild 72.69 Southfield Junior 60.69 Southfield Infants' 65.00 St. Mary's R.C., Turnham Green 54.39 West Acton 79.79 36 INOCULATIONS — 1945. School. Primary Schick. 1944 Old Cases. Doses. 1945 Doses. Schick tested after 3 years. ''Boost'' Dose. Pos. Neg. 2nd. 3rd. 1st. 2nd. 3rd. Pos. Neg. 1st. 2nd. 3rd. Acton Wells Upper — — — — 5 4 3 6 15 — — — Acton Wells Lower 2 1 1 1 9 7 4 — 2 17 — — Berrymede Boys 9 2 1 2 12 8 5 3 8 33 — — Berrymede Girls 9 3 12 9 15 11 6 4 3 37 1 — Berrymede Infants — — 1 9 13 9 3 — — 22 — — Beaumont Park Seniors 2 1 — 1 7 6 5 5 5 9 — — Beaumont Park Infanta 1 — 1 3 7 7 5 2 — 9 — — Central 7 1 6 6 12 9 6 6 15 — — — Derwentwater Juniors 9 6 1 1 13 10 9 2 5 39 — — Derwentwater Infants 1 2 1 11 8 7 6 — 1 42 — — John Perryn Upper — — — 1 — — — 1 7 3 — — John Perryn Lower — — — — 4 4 4 — 1 37 — — Priory Boys 5 8 1 1 7 4 1 8 29 — — — Priory Girls 2 2 3 3 5 3 1 4 33 — — — Priory Infants — — 4 2 13 7 6 — 1 53 — — Southfield Junior 6 12 2 1 14 9 9 7 36 8 — — Southfield Infants 5 — 1 1 18 13 10 — 1 68 — — Rothschild 1 1 5 3 7 6 6 — 4 40 — — Roman Catholic 3 — — — 6 2 2 1 3 5 — — West Acton 1 — — 3 2 2 2 — — 44 — — Other Schools 1 6 — 1 6 4 3 5 13 17 — — TOTALS 64 45 40 59 183 132 96 54 182 483 1 — 37 DISTRIBUTION OF SCABIES, 1945. Acton Wells. Stevenson Street Baths „ Treatment 4 children Canada Crescent Baths „ „ Wales Farm Road Baths „ „ 2 children North Acton Road Baths „ „ 2 children Newark Crescent Baths „ „ 2 children Leamington Park Baths „ „ Harold Road Baths „ „ 5 children Beaumont Park. Berrymede Road Baths „ Treatment Antrobus Road Baths „ „ Bridgeman Road Home „ 2 children Acton Lane Baths „ „ Berrymede Road Home „ Priory Road Baths „ „ Berrymede Road Baths „ „ Berrymede Road Baths „ „ Florence Road Home „ Acton Lane Baths „ „ Berrymede Road Baths „ „ Berrymede. Willcott Road Baths „ Treatment Gloucester Road Baths „ „ Hillcrest Road Baths „ „ Palmerston Road Baths „ „ Berrymead Gardens Baths „ „ 2 children Bollo Bridge Road Baths „ „ Stirling Road Baths „ „ 4 children Stirling Road Baths „ „ 6 children Packington Road Baths „ „ 2 children Stirling Road Baths „ „ Avenue Road Baths „ „ Berrymead Gardens Baths „ „ Colville Road Baths „ „ Bollo Bridge Road Baths „ „ 2 children Newton Avenue Baths „ „ Wilcott Road Baths „ „ Stirling Road Baths „ „ Berrymead Gardens Baths „ „ Avenue Road Baths „ „ Pamerston Road Baths „ „ 2 children Hillcrest Road Baths „ „ 3 children Packington Road Baths „ „ 2 children 38 DISTRIBUTION OF SCABIES—contd.. Derwentwater. Buxton Gardens Baths Treatment Goldsmith Avenue Baths „ 2 children Burlington Gardens Baths „ 5 children Grafton Road Baths „ Hereford Road Baths „ Alfred Road Baths „ Woodhurst Road Baths „ 3 children Birkbeck Avenue Baths „ Pierrepoint Road Baths „ Cumberland Road Baths „ Birkbeck Avenue Baths „ Lynton Road Baths „ Nemoure Road Baths „ Goldsmith Road Baths „ John Perryn. St. Dunstan's Gardens Baths Treatment. Priory. Buxton Gardens Baths Treatment. Stirling Road Baths „ 2 children Burlington Gardens Baths „ Church Road Baths „ Stirling Road Baths „ Churchfield Road Baths „ The Vale Baths „ Birkbeck Grove Baths „ Berrymede Road Baths „ Berrymede Road Baths „ Southfield Road Baths „ Winchester Street Baths „ Leythe Road Baths „ Avenue Road Baths „ Acton Lane Baths „ Ramsay Road Baths „ Avenue Road Baths „ Packington Road Baths „ Birch Grove Baths „ Woodhurst Road Baths „ St. Mary's. Park Road N. Baths Treatment. 2 children Leythe Road Baths „ Burlington Mews Baths „ Leythe Road Baths „ Grosvenor Road Baths „ Northfield Road Baths „ Rothschild. Antrobus Road Baths & Home Treatmt. 2 children Rothschild Road Baths Treatment. Kingswood Road Baths „ Antrobus Road Baths „ Acton Lane Baths „ 2 children Berrymede Road Baths „ 39 DISTRIBUTION OF SCABIES—contd. Southfield. Weston Road Home Treatment. Rusthall Avenue Baths „ Rothschild Avenue Baths „ Valetta Road Baths „ Acton Lane Baths „ The Vale Baths „ Valetta Road Baths ,, 2 children Whellock Road Baths „ Dordrecht Road Baths „ Agnes Road Baths „ West Acton. Canada Road Baths Treatment. Central. St. Dunstan's Avenue Home Treatment. EAR AND NOSE CLINIC. Ear Treatment Only. Number attending with Otorrhoea 17 „ „ Boils — „ „ Mastoid swelling 1 „ „ Earacha 4 „ „ Wax 24 „ „ Other Ear diseases — „ „ referred but did not attend — Total 46 (8 cured, 4 better, 5 failed for further treatment). Nose Treatment. Nasal and post nasal Catarrh. Number cured 61 „ improved 38 „ complicated by other conditions — „ referred for Specialists' opinion — „ referred to Hospital 15 „ who did not report for examination after treatment 18 „ referred, but did not attend 21 „ who failed to complete treatment 13 „ continuing treatment 1 Total 167 40 Nose and Ear Treatment simultaneously. Cases suffering from Otorrhoea and post nasal Catarrh. Number cured 3 „ referred to Specialist — „ who ceased to attend — „ irregular in attendance (not seen after treatment) 3 „ continuing treatment — „ referred to Hospital 1 „ referred, but did not attend 1 Total 8 Number of children sent for Audiometric examination 9 REPORT OF THE SCHOOL OCULIST. During the year 1945 the following numbers of children were examined:— Elementary and Secondary Schools 338 From Infant Welfare Clinics 30 Spectacles were prescribed in 198 cases. One child was referred for orthoptic treatment. Three for operation (2 cases of squint and one cyst). One child was referred to a myope school. (Signed) V. E. Brander. REPORT OF THE SCHOOL DENTAL SURGEON. Since July 1945 two whole time dentists have been employed. Children who were evacuated have returned—those who received dental treatment while away are in a very good condition, but the others need numerous extractions. An orthodontic centre was opened at Southall in September where children now receive necessary treatment. 41 44 children were referred November—December '45. In general the teeth of children between the age of three and five years are fairly good. The mouths of expectant mothers who have been in the services are in a better condition than most of those who attended the clinic. As seen from the figures below over 50% of mothers refuse fillings. Dental Report—Maternity and Child Welfare (1945). Mothers examined 250 Mothers referred 245 Mothers treated 116 Children examined 56 Children referred 51 Children treated 34 Permanent fillings 353 Permanent extractions 230 Temporary fillings 51 Temporary extractions 16 Dressings: Perm.—125. Temp.—109. Number of attendances 518 Number of dentures supplied 27 Scale and clean 69 E. Behr. REPORT OF THE SPEECH THERAPIST. During 1945 a total of 40 children have received treatment for defective speech. Some of these have attended twice weekly in small groups of 3—6 for periods of 45 minutes; the remainder have had individual treatment once weekly for 25 minutes. Of the 40 treated:— 11 have been discharged cured. 5 left school (3 were almost cured). 1 left the district. 1 ceased to attend at the parents' request. 2 have been temporarily discharged, but will be re—admitted if they require further treatment. 42 Of the 20 who require further treatment:— 3 have made excellent progress. 9 have made very good progress. 7 have made satisfactory progress. 1 attended very irregularly. Parental co—operation has been very good throughout the year, and it is apparent that the value of Speech Therapy is becoming more widely known and appreciated in the Borough. Eileen Richnell. SPECIAL SCHOOL. This School for the educationally retarded was open for the whole of 1945, and at the end of the year 14 children were on the roll. During the year 2 new cases were admitted. EXCEPTIONAL CHILDREN. Defect. In Hospital. Residential Special or O.A. School. Ordinary Elementary School. Evacuated. At Home. Total Tuberculosis — 2 14 — 5 21 Delicate 1 6 17 1 2 27 Asthma — 1 18 — 1 20 Rheumatism 1 — 15 — — 16 Perthe's disease 3 — 2 — — 5 Crippled — — — — — — Epilepsy — 2 3 — 1 6 Cretinism — — 1 — — 1 Partially Deaf and Deaf & Dumb — 8 — — — 8 Blind and Partially Blind — — 2 — — 2 Imbecile — 6 — — 10 16 Maladjusted — 4 1 — — 5 43 VISITS PAID BY SCHOOL NURSES. Acton Wells 58 Beaumont Park 35 Berrymede 45 Derwentwater 65 Central 3 John Perryn 52 Priory 37 Rothschild 67 Roman Catholic 8 Southfield 75 West Acton 37 Special 6 MEDICAL INSPECTION RETURNS. TABLE I. A.—Routine Medical Inspections. Number of inspections in the prescribed groups— Entrants 735 Second Age Group 351 Third Age Group 616 Total 1,702 Number of other routine inspections — Grand Total 1,702 B.—Other Inspections. Number of Special Inspections and Re-Inspections 1,242 TABLE II. Classification of the Nutrition of Children inspected during the year in the Routine Age Groups. A. B. c. D. Age Groups. Number of Children Inspected. (Excellent) (Normal) (Slightly subnormal) (Bad) No. % No. % No. % No. % Entrants 735 294 40. 394 53.6 47 6.4 — — Second Age Group 351 117 33.3 199 56.7 35 10.0 — — Leavers 616 159 25.82 395 64.11 60 9.74 2 .33 44 TABLE III. Group 1.—Treatment of Minor Ailments (excluding uncleanliness). Total number of defects treated or under treatment during the year under the Authority's Scheme 4,221 Group 2.—Treatment of Defective Vision and Squint. Errors of Refraction (including squint) (under the Authority's Scheme) 298 Other defects or disease of the eyes, excluding those recorded in Group 1 2 Total 300 Number of children for whom Spectacles were (a) Prescribed 155 (b) Obtained 152 Group III.—Treatment of Defects of Nose and Throat. Received operative treatment 20 Received other forms of treatment 243 Total number treated 263 TABLE IV. Dental Inspection and Treatment. (1) Number of pupils inspected by the Dentist. (a) Routine age-groups 2,872 (b) Specials 656 Total (Routine and Specials) 3,528 (2) Number found to require treatment 2,304 (3) Number actually treated 1,093 (4) Attendances made by pupils for treatment 2,815 (5) Half-days devoted to:— Inspection 37 Treatment 564 Total 601 (6) Fillings:— Permanent Teeth 1,848 Temporary Teeth 1,282 Total 3,130 45 (7) Extractions :— Permanent Teeth 104 Temporary Teeth 841 Total 945 (8) Administrations of general anaesthetics for extractions 590 Local 11 Total 601 (9) Other Operations:— Permanent Teeth 349 Temporary Teeth 156 Total 505 These numbers include boys at the County School treated between January 1st and March 31st, 1945. TABLE V. Verminous Condition. 1. Average number of visits during the year by the School Nurses or other authorised persons 160 2 Total number of examinations of pupils in the Schools by School Nurses or other authorised persons 15,061 3. Number of individual pupils found unclean 773 TABLE VI. Blind and Deaf Children. Number of totally or almost totally blind and deaf pupils who are not at the present time being educated in a Special School, including evacuees resident in the Authority's area. 1. 2. 3. At a Public Elementary School. At an Institution other than a Special School. At no School or Institution. Blind Children — — — Deaf Children — — — Mental Deficiency Act, 1913. Total number of children notified during the year ended 31st December, 1945, by the Local Education Authority for the purpose of the above-named Act was 2 46 AVERAGE HEIGHTS AND WEIGHTS—ENTRANTS. School. BOYS. Total No. Seen. 3 Yrs. 4 Yrs. 5 Yrs. 6 Yrs. 7 Yrs. No. seen. Ht. Wt. No. seen. Ht. Wt. No. seen. Ht. Wt. No. seen. Ht. Wt. No. seen. Ht. Wt. Acton Wells 14 1 41.5 42. 12 42.78 41.06 1 47. 47.5 Beaumont Park 14 3 39.33 35.43 6 40.45 36.87 5 43.12 42.25 Berrymede 61 15 37.78 34.1 21 41.07 39.27 17 42.94 43.41 5 47.22 51.5 3 48.1 54.83 Derwentwater 66 3 38.5 34. 14 41.32 39.75 38 43.06 42.42 7 45.95 49.14 4 48.75 55.87 John Perryn 49 13 38.81 35.76 14 40.98 38.66 16 43.91 44.43 3 46.26 47.5 3 47.7 49.16 Priory 45 8 37.06 34.99 15 40. 38.12 17 42.97 43.31 5 45.6 48.36 Roman Catholic 22 9 42.45 41.2 7 42.75 40.28 3 47.33 48.5 3 49.43 53. Rothschild 16 4 39.57 38. 4 41.2 39.62 3 44.2 43.66 2 41.5 38. 3 47.63 52.33 Southfield 54 7 39.1 34.9 7 41.73 40.33 29 43.66 42.71 9 47.18 51.81 2 45.15 46.4 West Acton 33 3 37. 37.5 11 41.56 39.59 11 43.35 42.38 6 47.41 52.66 2 47. 51.25 374 56 38.39 35.58 102 41.22 39.54 155 43.27 42.59 40 46.05 48.43 21 47.59 51.29 GIRLS. Acton Wells 20 16 44. 42.48 4 44.75 45.2 Beaumont Park 21 2 38.4 31.65 6 41. 39.62 6 42.93 40. 5 45.5 47.31 2 48.25 48.5 Berrymede 61 11 37.29 32.22 18 39.79 37.52 18 42.07 30.64 11 45.06 44.64 3 48.43 56. Derwentwater 67 3 37.5 32.26 10 40.46 38.45 36 42.7 40.5 16 45.33 47.15 2 47.25 46.75 John Perryn 35 8 38.47 33.87 5 41.52 39.76 12 43.16 41.1 7 46.75 48.11 3 47.6 55.6 Priory 42 10 37.63 34.53 6 38.3 35.43 20 42.1 41.77 4 42.95 41.75 2 45.5 43.5 Roman Catholic 21 2 41.25 35.75 14 44.16 42.85 4 45.43 46.5 1 46.8 44. Rothschild 14 1 34. 5 29.5 5 39.44 33.46 5 42.6 38.38 2 43.15 40.5 1 43.3 42. Southfield 33 5 34.96 32.46 6 39.05 37.55 16 44.83 43.98 3 47.93 54.66 3 47.33 55.1 West Acton 47 4 39.52 36.75 20 41.27 38.84 11 43.9 42.93 8 46.63 48.5 4 49.31 59. 361 44 37.28 32.90 78 40.23 37.36 154 43.24 41.36 64 45.34 46.43 21 47.08 50.07 47 AVERAGE HEIGHTS AND WEIGHTS—INTERMEDIATES. School. BOYS. Total No. Seen. 8 Yrs. 9 Yrs. 10 Yrs. 11 Yrs. No. seen. Ht. Wt. No. seen. Ht. Wt. No. seen. Ht. Wt. No. seen. Ht. Wt. Acton Wells 15 15 50.48 59.52 Berrymede 40 40 48.82 57.11 Derwentwater 39 38 50.45 58.52 1 51.5 52. John Perryn 16 16 50.28 57. Rothschild 21 21 49.95 57.62 Southfield 18 18 50.19 58.82 Roman Catholic 4 4 52.08 62.81 West Acton 10 10 50.63 59.55 163 162 50.36 58.87 1 51.5 52. GIRLS. Acton Wells 15 15 51.34 61.1 Beaumont Park 28 28 51.12 59.14 Berrymede 49 49 49.6 51.18 Derwentwater 38 37 49.67 55.78 1 48.5 46.5 John Perryn 16 15 49.59 56.14 1 57.8 79. Southfield 29 29 50.72 58.91 Roman Catholic 5 5 49.51 52.25 West Acton 9 9 50.5 60.75 189 187 50.26 56.89 1 48.5 46.5 1 57.8 79. 48 AVERAGE HEIGHTS AND WEIGHTS—LEAVERS. School. BOYS Total No. Seen. 12 YEARS. 13 YEARS. 14 YEARS. No. seen. Ht. Wt. No. seen. Ht. Wt. No. seen. Ht. Wt. Acton Wells 28 28 61.42 97.09 Central 39 38 62.6 100.66 1 64. 107.5 John Perryn 19 1 54.5 66. 18 60.45 93.69 Priory 71 63 59.77 94.47 8 60.48 97.42 Southfield 26 24 59.86 94.87 2 67.75 134.9 Turnham Gn. R.C. 9 9 60.09 97.08 192 1 54.5 66. 180 60.69 96.31 11 64.06 113.27 GIRLS Acton Wells 23 23 61.83 101.88 Beaumont Park 11 11 62.2 104.25 Central 42 33 61.63 106.39 9 61.31 99.5 John Perryn 22 1 57. 83.5 19 62.25 104.97 2 62.4 101. Priory 77 71 60.98 102.02 6 59.96 82.7 Turnham Gn. R.C. 7 7 59.92 93.67 182 1 1 ■ 57. 83.5 164 61.46 102.19 17 61.22 94.4