COUNTY BOROUGH OF WALLASEY. ANNUAL REPORT OF THE Medical Officer of Health AND School Medical Officer FOR THE YEAR 1941 RONALD B. BERRY, M.D., Ch.B., D.P.H., Medical Officer of Health , Medical Superintendent of the Corporation Infectious Diseases Hospital , Administrative Tuberculosis Officer , School Medical Officer , etc. Willmkr Bros. & Co., Ltd., Birkenhxad. 19 4 2 f COUNTY BOROUGH OF WALLASEY. ANNUAL REPORT OF THE Medical Officer of Health AND School Medical Officer FOR THE YEAR 194 1. RONALD B. BERRY, M.D., Ch.B., D.P.H., Medical Officer of Health , Medical Superintendent of the Corporation Infectious Diseases Hospital , Administrative Tuberculosis Officer, School Medical Officer, etc . Willmer Bros. & Co., Ltd., Birkenhead. 1 y 4 2 CONTENTS Ante-natal . 8 Ambulance Facilities . 12 Bakehouses . 25 Birkenhead Municipal Hospital 10 Births . 4 Blind Persons Acts, 1920-1938 20 Page Maternal Mortality . 4 Maternity and Child Welfare 8 Maternity Hospital . 9 Maternity Emergency Unit ... 11 Measles . 15 Midwives Act . 12 Milk and Dairies Orders . 21 Milk for School Children . 22 Clinics and Treatment Centres 8 Census . 4 Child Life Protection . 13 Deaths . 5/6 Diseases of Animals Acts . 23 Disinfection and Isolation Arrangements . 15 Disinfestation . 24 Drain Reconstruction . 23 Economic Conditions . 8 Evacuation . 9 Factory and Workshop Inspection . 25 Fertilizers and Feeding Stuffs 21 Food and Drugs Inspection ... 21 Highfield Maternity Hospital 9 Hospitals . 7 Houses, Inhabited . 4 Housing . 20/21 Neo-natal Deaths . 4 Nutrition . 11 Ophthalmia Neonatorum . 12 Population . 4 Public Assistance . 7 Rag Flock Acts . 25 Rats and Mice Destruction ... 25 Refuse Disposal . 20 Sanitary Circumstances of the District . Scabies . . . 23 . 15 School Inspection . . Appendix Sewers . . 23/24 Shop Hours Acts . . 25 Shops and Slaughter House Inspection . . 22 Statistical Summary ... . 4 Tuberculosis . . 16 Immunisation . 14 Infant Mortality . 14 Infectious Diseases, Prevalence of and control over . 14 Isolation Hospital . 15 Laboratory Work . 19 Vaccination . 15 Venereal Diseases . 19 Victoria Central Hospital . 7 Vital Statistics . 4 Wallasey Cottage Hospital . 7 Whooping Cough . 15 3 Public Health Department, October, 1942. The Mayor, Aldermen and Councillors of the County Borough of Wallasey. Mr. Mayor, Ladies and Gentlemen , I have pleasure in submitting my Annual Report for the year 1941. This Report is again, for obvious reasons, considerably reduced in size, and little more than a series of statistical tables. There is no direct evidence that war conditions have deleteriously affected, to an appreciable extent, the health of the people of Wallasey, though possibly an increase in the Infant Mortality Rate might be attributed to these conditions. There has been here, as elsewhere, an increase in the incidence of Scabies, and steps have been taken to deal with it. The work of the Department was, as everybody knows, carried oui under very difficult conditions, and I should particularly like to put on record my appreciation of the services of the Matron and Staff of the Mill Lane and “ Highfield ” Hospitals for their extremely fine work in March, when, on account of enemy action one Hospital was damaged, and both had to be evacuated. Others sections of the Department had to carry on under similiar difpcidt conditions, and the way in which the staff has given of their time and energy is worthy of commendation. The evacuation of Expectant Mothers was made possible when the Cheshire County Council opened a Maternity Home at Neston, with the assistance of some of our staff. We also had to send staff from our Isolation Hospital to Clatter- bridge when we transferred patients to that Hospital. Dormitory Shelters caused a certain amount of concern, but regular and frequent cleansing kept them free from serious infestation, and isolation accommodation for suspicious cases appeared to be effective in preventing the development of epidemic conditions. Over¬ crowding in these shelters was, at times, unavoidable. Dr. Stacey, Deputy Medical Officer of Health for 21 \-years, retired at the end of the year. The Committee have, as always, been considerate and given me their support, and I should like to express my thanks. I am, Mr. Mayor, Ladies and Gentlemen, Your obedient servant, RONALD B. BERRY, Medical Officer of Health. 4 GENERAL STATISTICS. Area in Acres, as ascertained by Ordnance Survey, January, 1932 5,908 River and Sea frontage . Slightly less than eight miles. Census Population, April, 1931 97,626 Registrar-General’s estimated population at middle of 1941 72,060 Inhabited houses at 31st December, 1941 . | * Information Empty ,, ,, ,, ,, ... ... j not available. Rateable Value, 1939-1940 . £877,164 1940- 1941 ... 1941- 1942 ... Information not available Yield of a Penny Rate £2,666 Live Births — Legitimate Illegitimate For Birth Rate. Total M. F. 1037 523 514 54 32 22 1091 555 536 For Infant and Maternal Mortality Total M. F. 960 478 482 54 32 22 1014 510 504 Birth Rate — 15.1 Still Births, 43. Rate per 1,000 total (live and still) births — 39.4 M F Totals Deaths to Dec. 31st ... ... ... 690 640 ... 1,330 Death-rate per 1,000 of estimated population ... ... 18-4 Uncertified Deaths : — 4 ; Percentage of Deaths 0.30: — . Deaths from diseases and accidents of pregnancy and child¬ birth (Headings 29 and 30 of Registrar-General’s Short List) : — Puerperal Sepsis 2. Rate per 1,000 live and still-births 1.89 ( Total Other puerperal causes — 3. do. 2.84 { 4.73 Deaths of Infants under ONE year of age . 80 Death-rate of Infants under ONE year of age : — - All infants per 1 ,000 live births ... ... 78.9 Legitimate infants per 1 ,000 legitimate live births 78.1 Illegitimate infants per 1,000 illegitimate live births... ... ... ... ... ... 92.6 Neo-Natal Rate per 1,000 births ... ... ... 35.5 Deaths from Measles (all ages) ... ... ... ... — Deaths from Whooping Cough (all ages) ... ... ... 4 Deaths from Diarrhoea (including Enteritis), under 1 year 5 1 - Under 2 years ... ... ... ... ... ... — f Diarrhoea and Enteritis Mortality Rate under 1 year, per 1 ,000 live births ... ... ... ... ... ... 4.93 * Owing to the large number of premises damaged by enemy accion, also the movement of population, these figures are not available. 5 STATISTICAL SUMMARY OF DEATHS DURING THE YEAR 1941. 6 Sexes. Causes of Death. M. F. All Ages An _ f Certified .... 688 638 1326 All causes ^ Uncerlified . 2 2 4 1. Typhoid and Para- typhoid fevers • • • • • • 2. Cerebro-spinal fever . . 1 2 3 3. Scarlet fever . 1 • • 1 3. Whooping Cough • • 4 4 5. Diphtheria . 3 7 10 6. Tuberculosis of respir- atory system .... 35 14 49 7. Other forms of Tuber- culosis . 4 6 10 8. Syphilitic diseases .... 4 2 6 9. Influenza . 10 10 20 10. Measles . • • • • • • 11. Acute polio myelitis & polio encephalitis . . • • • • • • 1 2 . Acute infective enceph- cLlltlS •••••••••••• • • • • • • 13. Cancer of buc. cav. oesoph M. & uterusF 10 9 19 14. Cancer of stomach and duodenum . 12 10 22 15. Cancer of Breast .... • • 13 13 16. Cancer of all other sites 51 38 89 17. Diabetes . 3 8 11 18. Intercranial vascular lesion® . 50 61 111 19. Heart disease . 146 140 286 20. Other diseases of circu- culatory system 10 11 21 21. Bronchitis . 44 31 75 22. Pneumonia . 37 28 65 23. Other respiratory dis- 8 9 17 eases . 24. Ulcer of stomach and duodenum . 10 2 12 25. Diarrhoea (under 2 yrs.) 4 1 5 26. Appendicitis . • • 4 4 27. Other digestive diseases 9 12 21 28. Nephritis . 12 17 29 29. Puerperal and post abortive sepsis .... • • 2 2 30. Other maternal causes • • 3 3 31. Premature birth .... 9 9 18 32. Congenital malforma- 10 10 20 mations . 33. Suicide . 5 1 6 34. Road traffic accidents 10 1 11 35. Other violent causes . . 135 101 236 36. All other causes . 57 74 131 Totals . 690 640 1330 Deaths due to Enemy Action. (included in 35 above) 122 92 214 Deaths in Whole I District, Total Deaths in Institutions in the Borough whether of residents or non¬ residents. Under 1 5 Under 15 45 Under 65 Over 65 80 30 22 200 370 624 204 • • • • • • • • 2 2 • • • • • • • • 2 • « 1 • • 2 • • 1 • • 1 3 1 • • • • 1 9 • • 1 6 2 26 18 3 13 2 2 1 3 • • 2 7 2 3 1 • • 3 1 2 • • • • 3 • • • • 11 • • • • 2 • • • • • • 1 • • 9 • • 9 • • 1 3 11 8 2 • • 8 5 1 11 36 42 18 2 4 5 5 • • 29 82 12 • • 1 14 75 196 18 • • 4 17 2 3 6 20 46 6 13 2 2 6 13 29 9 1 3 5 8 6 2 5 5 7 5 2 • • 1 3 2 1 2 2 8 8 5 • • 7 10 12 14 2 • • • • 1 • • 3 • • • • 1 18 • • 4 20 • • • • • • 4 2 3 1 2 1 1 2 6 1 • • 5 11 11 84 77 48 35 6 1 1 15 24 84 15 80 30 22 200 372 626 204 3 10 12 91 63 35 DEATHS IN PUBLIC INSTITUTIONS. IN WALLASEY. Mill Lane Hospital — Residents . 22 Non-Residents . 1 Highfield Maternity Hospital — Residents . Non-Residents . 8 Victoria Central Hospital — Residents . 95 Non-Residents . 11 Wallasey Cottage Hospital — Residents . 49 Non-Residents . 3 Leasowe Children's Hospital — Residents . — Non-Residents . 14 Other Public Institutions — Residents . 1 Non-Residents . — Total 204 ELSEWHERE. Liverpool and Other Hospitals Excluding Sanatoria) . Birkenhead Municipal Hospital County Mental Hospital . . . . Other Mental Hospitals . Sanatoria outside Wallasey . . . . Total •••••• 132 177 16 3 2 328 Deaths Outside Wallasey — Not in Public Institutions . Inward Transfers . 64 Transferable Deaths — In Wallasey of Non-residents Outward Transfers . 63 INQUESTS. Residents (all Ages) . ^\>60 Non-Residents (all ages) . 35 j Legitimate Children — Under 1 year 1 and Under 2 years .... 3 2 years and over . 2 Illegitimate Children — under 1 year — 1 and under 2 years .... — 2 years and under 5 years — DEATHS OF CHILDREN UNDER 1 YEAR BELONGING TO WALLASEY. Wards Totals 1 2 3 4 5 6 7 8 9 10 1 l 12 13 14 15 16 17 Total 4 4 — 4 5 4 6 7 6 6 7 5 3 3 11 4 1 80 DEATHS OF ILLEGITIMATE INFANTS BELONGING TO WALLASEY. Wards 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 Total Under 1 year . . — — — 1 — — — 1 — 1 — 1 — — 2 — — 6 1 to 2 . . Over 2 . . — — — — — — — — — — — — ■ — — 1 ■ Totals . . — — — 1 — — — 1 — 1 — 1 — — 2 — — 6 CAUSES OF ILLEGITIMATE DEATHS UNDER 2 YEARS OF AGE. Reg . No. Trans. la. 316 la. 368 la. 418 la. 2 467 la. 245 la. Cause of Death. Gastro Enteritis, b. Prematurity Broncho-pneumonia Vomiting, Diarrhoea, b. Gastro Enteritis Marasmus (Twin 3flb.) Hare lip, cleft palate Prematurity, b. Spina Bifida . . Debility, b. Premature birth Age 1 mth. 5 mths. 2 mths. 1 week 22 hrs. 1 week. Digitized by the Internet Archive in 2018 with funding from Wellcome Library https://archive.org/details/b30228839 7 Zymotic Death-rate per 1,000 of population (excluding Diarrhoea) ... ... ... ... ... ... 0.20 Phthisis Death-rate per 1,000 of population 0.68 Respiratory Death-rate per 1 ,000 of population (excluding Phthisis) ... ... ... ... ... ... 2.18 PRINCIPAL CAUSES OF DEATH. Heart Diseases . 286 Intercranial Vascular Canr.pr . . . 143 Lesions . Ill Other Circulatory Diseases 21 Congenital Debility, Respiratory Diseases- Premature Births etc. . . . 38 Pneumonia . 65 4 Violent Deaths Bronchitis . 75 y 157 (including suicides) . 253 Other . 17 influenza . 20 Phthisis . 49 Other Digestive Diseases 21 Acute and Chronic Other Tuberculous Np.nhritis . . 29 Diseases . 10 HOSPITAL SERVICES (within the Borough). The following Hospitals and Institutions are PROVIDED by the LOCAL AUTHORITY within the Borough 1. Mill Lane Hospital : For Infectious Diseases (other than small pox). 2. Tuberculosis Sanatorium : One block, 22 beds, and one chalet Mill Lane Hospital. with one bed, for advanced and observation cases. 3. Highfield Maternity Hospital : 21 Beds. In addition to the above there are the following Voluntary Hospitals within the Borough : — 4. VICTORIA CENTRAL HOSPITAL : General Hospital with 136 Beds (including 18 for children). There is an out-patient department. There is also a charitable Dispensary on the same premises. 5. WALLASEY COl TAGE HOSPITAL : General Hospital with 41 beds, which are used for men, women and children as necessity arises. This Hospital also has an out-patient department. 6. LIVERPOOL OPEN-AIR HOSPITAL FOR CHILDREN LEASOWE : Orthopaedic Hospital with 236 beds (198 for children and 38 for adult females). Patients are admitted to this Hospital from various parts of the country. The Corporation has ten beds in this Hospital on terms. HOSPITAL SERVICES (Outside the Borough). BIRKENHEAD MUNICIPAL HOSPITAL : 125 beds are available at this Institution for sick, maternity and mental cases. PUBLIC ASSISTANCE. Admissions to : — B’head Municipal Instit’n 201 Eastham House . 10 B'head Municipal Hospital 361 County Mental Hospital ... 47 8 ECONOMIC CONDITIONS. The number of unemployed persons in the Borough in January, 1941, was 1,237, and in December, 507 as compared with 3,963 and 1,237 respectively in January and December, 1940. During, 1941, the following amounts were expended on Unem¬ ployment, etc. Benefit by the Wallasey Employment Exchange : — Agricultural Benefit . £187 7 4 General Scheme Benefit ... . £12,682 6 0 Unemployment Assistance Allowances ... £9,110 14 2 In addition the Public Assistance Committee expended £16,915 8s. 7d. on outdoor relief and £552 11s. 6d. to Unemploy¬ ment cases. MATERNITY AND CHILD WELFARE. The Clinics at which a doctor attends on each occasion, are held in the afternoon of the following days : — New Street Centre — Tuesdays. Field Road — Thursdays. Wallasey Village — Wednesdays Oakenholt Rd., Moreton — Tues. The number of attendances during the year was : — Children under one New Street Moreton New Brighton Wallasey Village Totals year of age Children between 2,376 2,046 1,200 1,103 6,725 one and five yrs. 81 166 296 344 887 ANTE-NATAL. A woman doctor is in attendance at each Clinic. Special cases are referred from these Clinics to the Consultant Obstetrician who visits Highfield Maternity Hospital and his services are available whenever required. The following figures summarise the work done at the Ante¬ natal and at the Post-natal Clinics during the year : — ANTE-NATAL. Expectant mothers on books at January 1st . 127 New cases during the year ... ... ... ... ... 488 Names on books at December 3 1st ... ... ... ... 134 Attendances of Expectant Mothers ... ... ... ... 1874 No. of Expectant Mothers attending Consultative Ante- Natal Clinic ... ... ... ... ••• ••• 4 ,, Attendances ... ... ... ... ••• ••• 4 First-visits to homes of Expectant Mothers ... ... ... 628 Revisits do. do. do. ... ... ... 291 9 EVACUATION. In March the Ministry of Health opened a Maternity Home at Neston for expectant mothers from Wallasey and other evacu¬ ation areas. In April a Hostel was opened where expe:tant mothers in the last month of pregnancy could stay prior to their admission to the Maternity Home. Both these institutions are administered by the Cheshire County Council on behalf of the Ministry of Health. During the year 115 expectant mothers were evacuated under these arrangements, ninety-seven of them being admitted to the Hostel. HIGHFIELD MATERNITY HOSPITAL. The accommodation at this hospital was again in great demand and many requests for admission had to be refused. Owing to enemy action the hospital was evacuated on 13th March, thirteen cases being transferred to Clatterbridge. No further cases were admitted to Highfield until 31st March and then only a limited number for several weeks. The highest number of cases in at any one time during the year was 21 on January 28th, and the lowest 2 on June 3rd (apart from the period March 1 3th— 3 1 st . With booking at this figure there is little opportunity for the admission of urgent cases, though they are taken if at all possible. During the year 276 cases were admitted : — In Hosp. No. of Confine¬ No. of Dis- Admit- Remain¬ Jan. 1/41 Admis¬ sions 1941 ments 1941 Children charged ted Undelivered after C’ment Abortion ing Dec. 31st 1941 Doctors' cases 7 156* 152§ 155f 2 2 1 6 Midwives cases 10 120 118 118 — 2* — 7 |4 Twins. §1 admitted 1940, *1 confinement in ambulance and 1 in air-raid shelter. Total Doctors’ cases No. of Stillbirths ... 16* 13 Infant Deaths ... 8 5 Maternal Deaths 1 1 * 5 anencephalic. Midwives’ cases 3 3 Total Repair of Perineum 94 Breech Presentation 16 Puerperal Pyrexia ... 2 Doctors’ Cases 60 13 2 Midwives’ Cases 34 3 Puerperal Pyrexia. — Two cases occurred during the year the causes being as follows : — Sapraemia ... Infant Deaths : — Tentorial Tear (precipitate labour ... ... ... 1 Prematurity ... ... 2 Intracranial Haemorrhage Convulsions ... ... 1 2 (to V.C.H.) Melacna Neonatorum ... 1 Tracheo ocoeph Fistula ... 1 Asphyxia Pallida . 1 Spina Bifida and Asphyxia 1 Puerperal Death : — 1 Congestive Heart Failure, Valvular Disease of Heart (Mitral and Aortic) Childbirth. The case was complicated by impaction of the head. The child also died — Intracranial Haemorrhage — Convulsions. ]0 Operations : — Caesarian Section 3 External Version ... 1 Forceps Deliveries 22 Manual Removal of Placenta Episiotomy . 11 etc V/ l» v • ••• ••• ••• f 3 Induction . 3 Blood Transfusion... 2 Complications : — Ante-Natal : — Albuminuria 7 Pelvic Deformity ... 1 Ante-Partum Haemorrhage 3 Pulmonary Tuberculosis ... 1 Hydramnios 9 Ad Post Natal (other than “ Pyrexia Cases) : — MOTHER. P P H a • ••• ••• ••• 1 Phlebitis... 1 Bronchitis . 1 Cellulitis Ankle .. . 1 Embolism (to V.C.H.) ... 1 (to Mill Lane Hospital) Pyelitis (B. Coli.) 1 Obstretric Shock 1 CHILD. Sticky eyes 2 Talipes ... . 1 Phimosis (circumcised) ... 6 Deformity of Mandible 1 Melaena . 1 Facial Paralysis... 1 The following Abnormal presentations were dealt with Breech 16 P 0 P • ••• ••• • • • 1 Consultations (with Obstetric Specialist) . 22 In the 120 Midwives’ cases doctors were called for 49 cases. the main conditions being as follows : — M other Child Ruptured Perineum 30 Sticky Eyes 1 Delayed Labour ... 4 Asphyxia . 1 A.P. Haem. 1 Sores 1 Retained Products 3 Breech 3 Other conditions 4 P.P.H . 1 46 3 Emergency Admissions ... 17 Trans, to Clatterbridge 13 MATERNITY CASES ADMITTED TO BIRKENHEAD MUNICIPAL HOSPITAL. The Corporation made a declaration under Section 5 of the Local Government Act, 1929, to the effect that as and from 1st October, 1939, all assistance granted by the Council under the Maternity and Child Welfare Acts, as amended by the Public Health Act, 1936, to persons ordinarily resident in the Borough, be granted by virtue of those Acts and not by way of Poor Law Relief. During the year 44 cases were admitted to the Birkenhead Municipal Hospital under this arrangement. 1 1 MATERNITY EMERGENCY UNIT. The Corporation has an arrangement with the Liverpool Maternity Hospital for the use in Wallasey of the Maternity Unit for dealing with difficult domiciliary obstetric emergencies. SUMMARY OF VISITS PAID BY HEALTH VISITORS. First visits and revisits to Infants under one year of age ... 5,475 Visits and revisits to Children one to five years of age ... 5,150 Total visits and revisits to children under one and up to five years of age for any purpose whatsoever, including 401 visits and revisits re Minor Infections ... ... ...11,026 Visits re notified Infectious Diseases ... ... ... ... 770 „ Infant Life Protection ... ... ... ... 56 and re-visits to expectant mothers ... ... ... 919 NUTRITION. NATIONAL DRIED MILK. Particulars of dried milk given free and also of the Milk sold are as under : — Number of packets given free during year ... 1021 To number of children under one year ... ... 80 ,, ,, over . Nil. Free Dried Milk — (other than National Dried Milk) — Lb. Packets given during the year ... ... 13 To number of Infants under one year ... ... 13 At a cost of . £1 Is. 8d. Milk Sold— Lb. Packets, 10,475 realising . £875 8s. 2d. MIDWIVES ACT. Twenty-one Midwives notified their intention to practise in the Borough during the year (excluding six at the Corporation Maternity Hospital and five Municipal Midwives). During 1941 the five Municipal Midwives attended 319 cases ; of these, 90 were attended as maternity Nurses. The following is a list of the causes for which Medical help was sought : — CONDITION OF MOTHER. Private M 'wives M'cipal M 'wives Tota Protracted labour 4 9 13 Retained placenta — 5 5 „ membranes — 2 2 Post-partum Haemorrhage ... 2 2 4 Ante-partum Haemorrhage ... 1 4 5 Laceration of Perineum 10 29 39 Albuminuria ... — — _ Rise of Temperature ... — 3 3 Uterine Inertia 1 7 8 Miscarriage — 1 1 Abortion — 1 1 Mal-presentation 1 — 1 Abnormal presentation — 5 5 General weakness — 4 4 Pyrexia — 4 4 Various other causes ... ... ... 2 CONDITION OF CHILD. 6 8 Feebleness of Infant ... 1 7 8 Prematurity 1 5 6 Inflamed Eyelids 1 21 22 Other conditions PUERPERAL PYREXIA. 6 6 There were four notifications of the year, one of which proved fatal. Puerperal Pyrexia during OPHTHALMIA NEONATORUM. Three of the Health Visitors are qualified to treat, by douching, the eyes of children suffering from Ophthalmia Neonatorum. Two cases were notified during the year. Both cases were cured with no impairment of vision. AMBULANCE FACILITIES. On the formation of the National Fire Service the responsi¬ bility of maintaining an ambulance service for accidents, etc. was transferred from the Watch Committee to the Health Committee. The vehicles, however, were not handed over until February. 19412, and the service was carried on by using civil defence vehicles. From September 15th until the end of 1941 the number of cases dealt with by this department was as follows : — Street, works and other accidents . 108 Cases of sudden illness ... ... ... ... 33 Maternity cases ... ... ... ... ... 7 Other cases ... ... ... ... ... ... 71 INFANT MORTALITY. Nett Deaths from Stated Causes in weeks and months under one year of age. Under 1 Week. 1—2 Weeks. 2—3 Weeks. 3—4 Weeks. Total under 1 month. 4 Weeks and under 3 months. 3—6 months. 6—9 months. 9—12 months. Total Deaths under 1 year. 24 5 4 3 36 11 15 14 4 80 — . — — — — — — " ■ — — — — — — — — — — 2 1 3 1 1 2 1 3 — — — — - . - - 1 1 ' 1 1 1 1 2 1 3 1 7 — — ■ — — — 4 1 1 5 1 1 3 1 13 2 3 5 ’ _ Q — 1 — 1 3 — — — — 1 3 • O i o 1 7 16 1 11 16 5 . 12 2 1 1 1 1 3 1 — — 1 3 A 1 5 3 3 2 8 o . 24 5 4 3 36 11 15 14 4 80 CAUSES OF DEATH. All causes — Certified Uncertified Small-pox .. Chicken-pox Measles Scarlet Fever . Whooping Cough . Diphtheria & Croup Influenza . . Erysipelas . Tubercular Meningitis Abdom’l Tuberculosis Other Tuberculous Diseases . culous) . Convulsions . Laryngitis . Bronchitis . Pneumonia (all forms) Diarrhoea . Enteritis . i Gastritis . Syphilis . Rickets . Injury at birth Atelectasis . ‘Congenital Malformations Premature Birth .Atrophy, Debility, Marasmus . Other Causes . Totals <0 <3 Q 79 1 2 4 2 2 10 1 8 l 1 4 10 18 1 14 79 CHILD LIFE PROTECTION. No, of persons who were receiving children for reward at Jan. 1st 24 do. on Register at December 31st ... ... ... 20 No. of children under 9 years on Register at Jan. 1st ... 20 do. Deaths of children during the year ... ... ... — do. Inquests on children dealt with under the Act ... — do. Children on Register at December 31st ... ... 6 do. Visits during the year . 56 Health Visitors who are Infant Protection Visitors ... 7 previous year 14 SES OF INFECTIOUS DISEASE (Including Tuberculosis) NOTIFIED IN WALLASEY DURING 1941. NOTIFIABLE DISEASE. Cases notifie d at ag( iS 1 Notifi¬ cations. 0-1 1-2 2-3 3-4 4-5 5-10 10-15 15-20 20-35 35-45 45-65 Over 65 ill-pox . — a FIJI 1 1 >entery . . 1 htheria (including Membranous Croup) 220 1 3 14 8 16 69 42 32 23 10 o — " ^sipelas . 19 8 10 1 rlet Fever . 83 — 1 5 6 6 41 11 5 8 — — — beric Fever 32 1 2 1 1 1 3 13 5 2 3 m srperal Pyrexia . 4 1 3 — — — ebro-Spinal Meningitis 19 1 2 4 — — 4 — 1 o 2 3 — iomyelitis . — pumonia 24 1 1 1 1 2 6 6 6 hthalmia Neonatorum 3 3 — Imonary Tuberculosis 67 2 5 28 10 21 1 rer forms of Tuber- culosis . 18 — — 1 1 — 5 1 2 3 2 3 asles . 146 2 4 13 9 9 78 10 12 8 — 1 — looping Cough . 179 14 19 14 21 15 93 3 — — — — — 1 cephalitis Lethargica — — — ““ lio-Encephalitis . — — — — — — - TOTALS . 815 22 30 54 46 ! 47 292 72 72 83 40 49 IMMUNISATION. During the year, 1193 children attended the Immunisation Clinic. The full course of treatment was administered to 951 of these children. PUBLIC HEALTH (SMALL-POX PREVENTION) REGULATIONS, 1917. No primary vaccinations or re-vaccinations were performed by the Medical Officer of Health during the year. DIPHTHERIA IMMUNISATION. TABLE SHOWING NUMBER OF CHILDREN IMMUNISED — BY AGE GROUPS. Total under 5 years of age at 31/12/41 543 Total under 15 years of age at 31/12/41 2,939 1941 X r— H 115 X X T-H 85 76 47 45 27 22 22 05 •^f - 951 1940 i X 23 27 o X 45 44 20 cu X r-H ' ' X 230 1939 i X X o r-H CU T— H 29 o X T— H X ' cu y—i ' CU X r— < 110 1938 i r— * cu t> 24 r-H X 206 230 120 X ' T— * t—h ' ' - ' - 657 1937 i X CU r-H T“"< 65 160 114 65 X r-« X 1 1 - - ' ■ ' 451 1936 i X 22 38 125 313 r— H CU cu o r— ( 25 X X X cu - ' 683 1935 i X 05 o - 06 o X 35 05 cu cu - ' 245 Age at date of Inoculation Under 1 year 1 year V) u rt 0) CM 3 years 4 years 5 years 6 years 7 years 8 years 9 years 10 years 11 years 12 years 13 years 14 years 15 years Over 15 years Total 15 VACCINATION. Statement of Vaccination for year ending 31st December, 1940 : Births ... ... ... ... ... ... ••• 1,144 Successfully vaccinated ... ... ... ... ... 519 Insusceptible ... ... ... ... ... ... 0 Had Smallpox ... ... ... ... ... ... — Died un vaccinated ... ... ... ... ... 50 Postponed by Medical Authority ... ... ... 10 Certificates of Exemption (Conscientious objection) ... 247 Removals certified ... ... ... ... ... 8 Removals not found and not accounted for ... ... 80 MEASLES. 112 cases were notified and 34 reported during 1941. None of the cases proved fatal. WHOOPING COUGH. 83 cases were notified and 98 reported during the year. Five cases were found not to be Whooping Cough. Four of the cases proved fatal. SCABIES. Owing to the increase in the number of cases of Scabies, a treatment centre was opened in May at the New Street Clinic. During the year 120 sessions were held at which 193 cases were treated. The number of attendances was 579. In addition a few cases who were unable to attend at the Clinic were given out¬ patient treatment at the Infectious Diseases Hospital, Mill Lane. DISINFECTION. Houses disinfected after fevers, Phthisis, etc. . . . . . . . . 593 Rooms disinfected .. .. .. .. .. .. .. 101 Books from Public, Private, or School Libraries disinfected . . 108 Articles disinfected .. .. .. .. .. .. .. 4,943 Articles destroyed . . .. .. .. .. .. .. .. 5q ISOLATION HOSPITAL. The accompanying table gives particulars of the cases admitted to Mill Lane Infectious Diseases Hospital during 1941 : — In Recov- Transferred T3 In Hospital Ad- ered and t 0 Hospital 1st Jan. mitted I)i8- Clatterbridge. Died 3 31stDec. 1941 charged 1941 Diphtheria . . 26 130 102 13 6* + 2 33 -(-Enemy action. Diphtheria Carriers 1 8 6 3 * 1 died 1942. laryngitis . Menin^i- rn us Paratyphoid B. + 4 2 — — 2 + 1 Sent in as Diph. 1 sent in as Quinsey. — 1 15 1 15 — — — sent in as A.S.M. Enteritis c Emaciation — 1 1 — — — sent in as Para. B. Scarlet Fever 13 41 38 13 — — 3 Puerperal Pyrexia Erysipelas 1 9 1 8 1 l — — ^hooping Cough . . _ 5 4 _ Tonsillitis — 38 21 _ _ 17 Sent in as Diph. 37. Neonatorum Measles 1 19 5 1 19 ft 1 1 1 1 1 1 1 1 1 Sent in as Quinsey 1 Mobella • • • • • • _ __ 1 1 Ewchro-spinal Meningitis Cbiclcen Pox — 11 2 8 1 1 2 — 1 *1 sent in as Measles from V.C.H. *.A.D. SJJulitis of Leg . . 'f'/Ocho-Pneuinonla — + 2 2 — — — -f sent in as Measles. — + 1 + 2 1 2 — — — -) from H’fleld M.H. -(-sent in as C.S.M. 42 295 239 27 10 2 fiO Owing to enemy action in March, it was necessary to tempor¬ arily evacuate the patients from Mill Lane Hospital. They were sent to the Wirral Joint Hospital Boaad at Clatterbridge. Two of the wards were damaged in March, and the remaining accommodation being insufficient, it was necessary later to send more cases to the Clatterbridge Hospital. The total number of Wallasey cases admitted to Clatterbridge Hospital were as follows : — Diphtheria... ... ... 52 Scarlet Fever ... ... 38 Whooping Cough ... ... 1 Measles ... ... ... 2 Cerebro Spinal Meningitis 7 Para Typhoid B. ... ... 8 TUBERCULOSIS. There has been a very large decrease of new cases attending the Dispensary. CONTACTS. There has been a marked decrease of Malnutrition among contacts for 1940 and 1941. DEATHS. Pulmonary Tuberculosis. 1941 1940 1939 No. of deaths 49 69 61 Death rate per 1 ,000 of population . . Cases dead within two years of notifi¬ 0.68 0.62 0.62 cation 32 29 33 Non-notified deaths . . 12 9 7 N on-Pulmonary Tuberculosis. 1941 No. of deaths . . . . • • • • • • • • 10 Death rate per 1,000 of population . . . . . . . . 0.13 Cases dead within two years of notification Non-notified deaths (1 Tubercular Peritoneum) . . . . 1 NOTIFICATIONS (Pulmonary). There were 67 notifications (Male 46, 20 H. M. Forces) Females 21, plus 9 transfers from other areas. NOTIFICATIONS (Non-Pulmonary). There were 18 notifications (7 Male, 1 1 Female) plus 2 transfers from other areas, and 4 from Death returns. CLASSIFICATION OF NON-PULMONARY TUBERCULOSIS. Abdomen . 8 Menges . 3 Bones and Joints . . 6 Other Organs . . . . 3 Cervical Glands . . 4 BIRKENHEAD MUNICIPAL HOSPITAL. Pulmonary Non-Pulmonary Cases admitted during 1941 . . 18 Discharged during 1941 . . . . 9 Died ,, 1941 .. .. U Total 18 9 11 Total number of Artificial Pneumothorax refills during the year 444 (200 Male, 244 Female— same as last year. 17 AFTER CARE. All patients after discharge from the Sanatorium are kept under observation and receive frequent visits from the Health Visitors with regard to Sanatorium regime. They are also en¬ couraged to attend the Dispensary for observation, where instruction and advice are given. Cod Liver Oil and a pint of milk daily are supplied to necessitous cases for varying periods, under an arrange¬ ment with the Wallasey Invalid Children’s Association, at the expense of the Local Authority. MILL LANE SANATORIUM. Adults Children Total Admitted during 1941 . 26 3 29 Discharged during 1941 . . . . . . 24 1 25 Fatal during 1941 9 • • • • • • c/ 1 10 CHESHIRE JOINT SANATORIUM. Males Females Total Admitted during 1941 8 7 15 Discharged during 1941 . . . . 9 10 19 LEASOWE OPEN-AIR HOSPITAL. Female Adults Children Total Admitted during 1941 4 • • • • X 7 11 Discharged during 1941 3 3 6 HOUSING. Of the 67 notifications of Pulmonary Tuberculosis : — 33 slept in separate bed and room. 1 slept in separate bed, but shared room. 16 shared bed and room (chiefly married couples). 10 not visited by request of medical practitioner. 3 notified from County Mental Hospital. 4 left district before visit. VISITS. The number of visits paid in 1941 by the Dispensary Nurses and Health Visitors was 1643 (Wallasey 1357, Moreton 286)— increased number in Moreton area. TUBERCULIN SKIN TESTS. Of 34 children tested— 30 were contacts of cases of Tuber¬ culosis. 73% gave a positive re-action. These cases will be kept under observation. Of the remaining non-contact cases only 25% showed a positive re-action. 362 X-ray examinations were made compared with 434 in 1940. 4 Orthopaedic cases were also X-rayed. In addition there were 35 examinations (30 male, 5 female) of candidates for admission to the Corporation Superannuation Scheme. FOR THE YEAR 1941 18 P H 8 o H fl d rj lx O O H a as u 42 r-H d T3 CM *0 »o t- as CM CM co as io >o CM ^-v CM co Children. pci CO | 1> 1 1 CM 3 34 29 " 1 2 20 3 32 24 Adults. F. CM 1 I- r-H | ^ 1 36 o i- 00 126 33 88 1 12 3 102 142 1 F. X | | 1 1 1 CM kr-i ^ 1 1 1 1 ! CM Pd CM CM Cl T* CO a o 6 *3 d as u 2 •H x3 a 42 r-H d t) < Pd CM SO Pd co 00 CM CM as CM co •H CO o a b£ Rl aj as >, as xi +-> tuO d t •c a T3 co Tj -t-> as d n flj bo TJ co 3 /5s _as o y d TO o 44 E d as o xs O 3 Cd £ to O p ° o §3 « 5 iM i! S'gss" r3 x< -d d H (J 7s d fc3- C , « n: 5? a £ as as .5 o ® — Q Q £ i*x _ _ <3 ^ vs M (3 as >-> as -d +j be d • H Vh d Td T3 as d TJ as to +-> O as £ 'a, 13 £ ° o o CO d o .. ^ -M _ t 3 o" a? -*-» d U S £>.2 s as on Xi 42 .t4 2 3 o c G a va w> A 4o.So oOQ^ o __ j to 0Q # >■> lx Rj C/3 d as a co as S3 4J T3 Jrf 4-> ►s ro .42 d -m be rJ as as co V O ^ d s. fcp c d Rj bo d T3 d — i d-i co o ^3 d d ^ as ^X a CO CO d co 3 rtT> -»-> lx as •r-1 as u H -p as £.2 > bo O co as o as 3 as O _ CO p II d as O lx in cl ai Xs co d « H 8 a u 0) £ s ~ o d d o 3 u Tj ^ ^ d d co io as rJ b rS I d ■ ■ as 4j Cd CO CO rH CO rs u fl £ ° £ 03 . . co o d as as o CO lx Rj P-1 as CJ -Q d d . O 4J T) as CO 4-> 3 as ° 34 S o o 4-1 o d >x X4\ 2 as as co d -o O S.2-g l dv ? d s? o d bo Rl QG « -o 19 VENEREAL DISEASE. The number of new cases for 1941 was 38 — a decrease on 17 on 1940, and 28 on 1939. After deducting the Non-Venereal cases, the number of definite cases was 21, which is 14 less than 1940. (This is the smallest number for any year on record). Attendances were : — 1941 1940 1939 Males .. .. 911 1,468 1,138 Females .. .. 182 112 129 A large increase of Female attendances. The following are particulars of 21 cases of V. D. Syphilis Gonorrhoea Males . . . . . . 2 9 Females . . . . . . 4 6 This is an increase of Female Syphilis — decrease in Male Gonorrhoea. 60 specimens in connection with the clinic were examined at the Laboratory, Mill Lane Dispensary. 24 specimens of blood were sent from the clinic for Wasserman re-action. Information has always been sought for and advice given to patients proceeding to other areas, re hours and places of attendance. Return of Wallasey Residents treated in Liverpool and Birkenhead areas during the year. Syphilis Chancre Gonorrhoea Conditions other than Venereal Total attendance of all cases L'pool B’l 6 9 2 — 14 5 15 7 37 21 596 306 There is a considerable increase in the number of Syphilis cases treated. Attendances are approximately the same. LABORATORY WORK. The arrangements for carrying out the bacteriological work in the Borough are : — Simple throat swabs in connection with Diphtheria cases, specimens of sputum in connection with Phthisis cases, and various discharges in connection with Venereal Diseases are examined at our own Laboratory, Mill Lane Dispensary. Blood specimens in connection with Venereal Diseases are sent to Liverpool Univer¬ sity Laboratories for examination. Specimens from cases, and suspected cases of Infectious diseases (Diptheria, Typhoid, etc.) are also sent to the Public Health Department Laboratory, Birkenhead. 20 Particulars in regard to these are : — Specimens Examined. Sputum ... 263 Throat Swabs ... 1688 Venereal ... 60 Number found to contain Tubercle Bacilli ... 47 Diphtheria Bacilli ... 171 Gonococci ... ... 21 BLIND PERSONS ACTS, 1920-1938. The duties of the Council under the Blind Persons Acts, 1920- 1938 are administered by the Health Committee. One Home Teacher is employed who paid 2,439 visits to blind persons during 1941. REGISTRATION OF BLIND PERSONS. No. on Register at January 1st M. 72 F. 81 Totals 153 No. added during the year : New Cases 1 4 5 Transfers from other towns 1 3 4 Totals ... 74 88 162 No. of Removals from Register owing to : — Leaving Wallasey 1 4 5 Death • . » ••• ••• ••• 4 4 8 Totals ... 5 8 13 No. on Register at December 31st 69 80 149 FINANCIAL ASSISTANCE. No. receiving assistance at January 1st „ receiving assistance at December 31st . Amount disbursed by way of allowances, January to December ... ... ••• ••• ••• £4,323 6s. 98 79 9d. MEDICAL EXAMINATION. During the twelve months ending 31s/ December, 1941, fifteen people were examined by Dr. H. R. Bickerton of whom five were found to be blind, while ten could not be certified. The average age of the ten blind people was 74 years 10 months. REMOVAL AND DISPOSAL OF HOUSE REFUSE. This work is carried out under the direction of the Borough Surveyor. There are no ashpits in the Borough. Particulars as to the quantities of refuse and salvage disposed of in the past year are as under : — 21 House, &c. Refuse — T. C. Q. Delivered to Refuse Disposal Works ... 7,761 19 0 Quantity tipped away 9,757 18 0 17,519 17 0 Salvage, &c. material... 1,138 11 0 18,658 8 0 Wet refuse collected in added areas and delivered to farms, 104 loads. HOUSING. No new houses were erected, or in course of erection, and no houses were converted into flats during 1941. No Demolition or Clearance Areas were scheduled during 1941. FOOD AND DRUGS ACT, 1938. During the year 148 samples were analysed, 13 of which were found to be adulterated. No proceedings were instituted during the year, the adulterations being so slight. The sellers were, however, cautioned. FERTILISERS AND FEEDING STUFFS ACT. Four samples of Fertilisers and one sample of Feeding Stuffs were submitted for analysis during the year all of which complied with the requirements of the Act. Control and Supervision of Milk Supplies (Biological Examination). Owing to enemy action the routine sampling of milk was curtailed. The following is a summary of the work carried out since 1938 : 1941 1940 1939 1938 Number of Milk samples taken ... 190 256 298 306 Number of positive results (T.B.)... 18 18 34 24 Percentage ... 9.47 7.03 11.31 7.84 Milk Production in Registered Dairies. There are 20 registered Cow Keepers in the Borough, 5 being licensed producers of Accredited Milk. In addition to the Dairy Farmers, there are 42 registered dairies, a number of which are licensed for the sale of milk under the terms of the Milk (Special Designations) Order, 1936-38. There are also 55 shops registered for the sale of milk in sealed bottles. Number of visits to Dairy Farms . . . . . . 42 „ „ Registered Dairy Premises . . 481 22 Designated Milks. The following is a summary of Licences issued by this Authority under the terms of the Milk (Special Designations) Order, 1936-38 Farms licensed for the production of Accredited milk . . 5 Dairies licensed to bottle and retail Tuberculin Tested milk 5 Dairies licensed to retail bottled Tuberculin Tested milk 15 Dairies licensed to produce Pasteurised Milk . . . . 2 Dairies licensed to bottle and retail Pasteurised Milk . . 7 During the year 9 samples of milk were submitted for bacteriological examination, three being found unsatisfactory. Milk in Schools. Under this scheme pasteurised milk is supplied to school-children in bottles containing one-third of a pint at a charge of |d. per bottle. Despite difficulties experienced with regard to short supplies of milk at various periods, the scheme was operated with the minimum of breakdowns and during the year 942,119 bottles were supplied, including 32,979 bottles which were supplied FREE by the Educa¬ tion Committee to necessitous children. Supervision of Meat Supplies. All home-killed meat consumed in Wallasey is brought into the Borough dead. Nevertheless strict control and supervision is exer¬ cised over both fresh and imported meat supplies at all retail shops including those premises where cooked meat and made-up products are prepared. All retail food shops and food manufacturers were, during the year, visited and supplied with advisory information with regard to the preventing of foodstuffs becoming gas contaminated. During the year, various unwholesome and diseased foodstuffs comprising fruit, vegetables, fish, poultry, rabbits, dairy produce and provisions, including miscellaneous tinned foods, were dealt with. Destruction was not insisted upon in every case. Wherever possible the material was used for animal feeding, and in some cases was disposed of for conversion into non-edible products at a local refinery. The total weight of meat dealt with in this manner was : — Meat, including pork and offals : 1,576 lbs (this includes carcases, parts of carcases and offals of animals slaughtered at the Wallasey and Alfred Lairage). Total number of visits to butchers and other shops 1,519. WALLASEY AND ALFRED LAIRAGES. Landing Place for Irish and Isle of Man Animals and Foreign Animals Landing Wharf. 35 cattle were slaughtered for emergency reasons. Routine post-mortem inspection was made in every case. One carcase, including all internal organs was destroyed as unfit for human consumption, together with parts and various organs of other carcases. 23 Administration of Diseases of Animals Acts and Orders. A number of suspected cases of Swine Fever were reported during the year, but in no case was the disease confirmed by the Ministry of Agriculture and Fisheries. Information was laid against a person for causing unnecessary suffering to sheep by allowing them to become maggot infested, causing the deaths of some of the animals. A second information was also laid for failing to bury carcases of sheep. On both charges he was convicted and fined. Inspections and examinations were made during the year with regard to the requirements contained in the Warble Fly (Dressing of Cattle) Order, 1938, whilst farmers and stock owners were notified and interviewed with regard to their responsibilities under regula¬ tions made by the Ministry concerning outbreaks of contagious disease. Inspections were also made of pig keepers’ premises to ensure the isolation of store pigs brought on to the premises under licences issued under the Movement of Swine Order of 1922. Visits to farms, piggeries and other premises : 235. SANITARY INSPECTION OF THE DISTRICT. WORK OF THE DISTRICT INSPECTORS. No. of houses visited . 3,012 Special complaints investigated ... ... ... ... 1,912 No. of defects discovered . ... 2,187 Interviews, appointments, supervisional visits and revisits 308 Matters dealt with from and to other departments . 201 Information laid . 4 Magistrates orders obtained . 4 Warrants to enter obtained . 1 Cases withdrawn on payment of costs or dismissed under the Probation of Offenders Act ... ... ... ... — Fines, etc. . £5 17s. 6d. Exchanging Toys for Rags Convictions . 1 „ fines and costs . 11/- )} )} ABATEMENT OF NUISANCES. No. of Notices served . 2,000 Reinspections . 3,971 Sewerage and Drainage. The water-carriage system is used throughout the Borough, the resulting crude sewage being discharged into the River Mersey at suitable points. Where necessary certain of the main Watercourses in the Western part of the Borough have been cleaned out and regraded to improved falls. The usual sewer flushing operations have been carried on during the year so far as prevailing circumstances permitted. 24 Sewer Construction. Information with regard to Sewerage is kindly supplied by the Borough Engineer and Surveyor. During the year Sewer work has been largely restricted to the repair of Air Raid damage which has involved the following work spread over some 105 incidents. Repair and reconstruction of 285 yards of 6 inch sewer. 9 9 9 9 9 9 405 „ 9 9 9 9 9 9 9 9 9 9 9 180 „ 12 9 9 9 9 99 9 9 9 9 25 „ 15 9 9 99 > 9 9 9 9 9 115 „ 18 9 9 9 9 9 9 99 9 9 100 „ 21 9 9 9 9 99 9 9 9 9 24 „ 27 9 9 9 9 9 9 99 9 9 43 „ 36 9 9 9 9 9 9 9 9 9 9 35 Manholes. No new sewers have been constructed during the year, but the diversion and relaying of 55 yards of 9 inch, and 35 yards of 6 inch sewer on the North side of Dock Road has been carried out. DRAIN RECONSTRUCTION AND TESTS. Drains reconstructed or partially reconstructed ... ... 12 Drain tests by smoke or water ... ... ... ... 34 FLUSHING. The Local Authority voluntarily flush the drains of all houses in the Borough. During the past year the drains of 16,604 houses were flushed. In addition, the drains at 95 schools, public buildings, etc., were also flushed. BYELAWS WITH RESPECT TO NUISANCES, ETC. No. of inspections and reinspections of stable yards 64 Notices served ••• • • • ••• ••• 1 Visits to Marine Stores ... ••• ••• ••• ••• 6 ,, encampments ... ••• ••• ••• • • • 14 Sub-let houses visited • • • ••• ••• • • • ... 104 Rooms inspected ••• ••• ••• ••• ... 312 Infringements • • • • • • ••• ••• ... — PUBLIC BUILDINGS. Visits to schools, theatres, picturedromes and Public conveniences 65 ICE CREAM PREMISES. No. of visits to premises where Ice Cream is sold ... ... 20 DISINFESTATION. Houses infested with vermin disinfested 102 102 • • • • • • • • • • • • 25 RAG FLOCK ACTS, 1911-1928. Premises visited where Rag Flock is used ... ... ... 6 FACTORY INSPECTION. No. of visits to Factories and Workplaces „ notices served for contraventions „ Factories on register ,, Workplaces „ . „ Visits to Outworkers BAKEHOUSES. No. of Bakehouses on register ... ... ... ... ... 80 Visits 167 Contraventions discovered ... ... ... . 15 Notices served ... ... ... ... ... ... ... 15 SHOP HOURS ACTS, 1912-1936. No. of cases pending 1 January, 1941 ... ... ... 1 Contraventions discovered ... ... ... ... ... 7 Convictions obtained ... ... ... ... ... ... 3 Cases dismissed under the Probation of Offenders Act ... 1 Cases pending, 31 December, 1941 ... ... ... ... — Warnings issued ... ... ... ... ... ... 4 Fines and Costs . £1 17s. Od. RATS AND MICE DESTRUCTION ACT. SUMMARY OF WORK DONE DURING THE YEAR. Complaints received ... 166 Baits consumed .. 165 Visits and re-visits ...2370 Rats caught .. 135 Notices served ... • • • ~ Mice found dead or caught .. 64 Traps set ... 146 Income for services of Rat¬ Baits laid ... 210 catcher ... ... £23 0 0 The above figures are much lower than usual owing to the absence of the Ratcatcher during the greater part of the year. 20 380 120 6 ? M# ' COUNTY BOROUGH OF WALLASEY EDUCATION COMMITTEE. Annual Report OF THE SCHOOL MEDICAL OFFICER For the Year 1941. 0 STAFF. RONALD B. BERRY, M.D., Ch.B., D.P.H. Medical Officer of Health and School Medical Officer. W. WRIGLEY STACEY, M.B., Ch.B., D.P.H. Assistant Medical Officer of Health and Assistant School Medical Officer to 31/12141. ELSIE J. D. SCOTT, L.R.C.P., L.R.C.S., D.P.H., Assistant Medical Officer to 5/2/41. MARGARET J. T. LEITCH, M.B., Ch.B., M.M.S.A., D.C.H. Assistant Medical Officer from 1/10/41. C. JOINSON LUYA, L.D.S. School Dental Surgeon. W. A. HENDERSON, L.D.S. (joined Forces 30/9/41). E. G. MASON, L.D.S. (joined Forces 21/4/41). Assistant School Dental Surgeons. Miss E. W. NICHOLLS (Certificate R.S.I.). Mrs. B. CHAPPELLS (Trained Nurse). School Nurses. Miss R. M. QUINTON (Certificate R.S.I.). Miss L. VANCE ( S.R.N. , S.C.M.). Miss B. JACKSON (S.R.N. , S.C.M.), Miss E. A. TEGGINS (S.R.N., S.C.M.), (1/1/41). Combined duties of School Nurse and Health Visitor. Miss M. OGLE (Certificates C.S.M.M.G., Diploma Liverpool University in Massage, etc.) Masseuse. H. R. BICKERTON, M.A., M.B., Ch.B., M.R.C.S., L.R.C.P. (Ophthalmic). R, J. MARTIN, M.B., Ch.B., D.L.O. (Ear, Nose and Throat). T. HARTLEY MARTIN, M.B., Ch.B. (Orthopaedic). Visiting Specialists. G. E. HUGHES, Education Office (Secondary Schools). R. L. BASCOMBE, Education Office (Elementary Schools). Clerical Assistants. 3 Town Hall , WALLASEY, 12 th May, 1942. To the CHAIRMAN and MEMBERS of the EDUCATION COMMITTEE. Ladies a'nd Gentlemen, The report of the work of the School Medical Department is again curtailed for obvious reasons. The work of this Department has always been seriously handicapped by the lack of proper accommodation. It has never been possible to centralise the records, nor has there been satisfactory provision for clerical assistance ; there is also no accommodation at all for doctors or nurses. All these diifficulties have been much increased during 1941, owing to the serious damage to the School Clinic. lThe various School Medical Services have had to be established in scattered centres throughout the town, and I consider that credit is due to the members of the staff for the way they have carried out their work in spite of these additional handicaps. Evacuation has also added to our difficulties, and many problems in evacuated children have received attention. The closing down of the Liverpool Child Guidance Clinic is a matter for regret, as I think it is generally recognised that the School Medical Services offers a valuable field for work of this nature. I should like to acknowledge the willing co-operation of the Director of Education and his staff, and also the valuable assistance rendered by Head Teachers. Extremely good work has been done by Inspector Banyard ( Chester ) of the N.S.P.C.C., in the absence of a local Inspector. I am, Your obedient Servant, RONALD B. BERRY School Medical Officer. 4 GENERAL. As in previous 3^ears, continuous examinations of the children in the schools have been carried out by the School Nurses, and those found in an unsatisfactory condition have received the necessary attention. In this respect, 195 visits to the schools were made in connection with Cleansing Surveys and 1692 to the homes of the children. Owing to damage to the premises of the Church Street Clinic by enemy action in March, it was found necessary to transfer the work of the Minor Ailments, Eye, Orthopaedic and Dental Clinics, to other premises. A policy of dispersal, as against previous centralization of Clinics, was agreed upon and arrangements planned according^. The Minor Ailments Clinic was set up in a suitable room of the Manor Road Council School, and with it the Eye Clinic, followed later by a second Minor Ailments Clinic in St. Joseph’s School, for the conve¬ nience of Schools at the south end of the district. The Dental Clinic was found accommodation at “ Thorn ville,” the school house of Egerton Grove School, which is in a central position, and from where it could operate and serve equally all areas of the Borough. The Orthopaedic Clinic was transferred and accommodated at the New Street Welfare Centre. Much of the technical equipment was saved and re-installed in the new premises of the respective Clinics. By these means the work was continuously maintained and successfully carried on. NUTRITION. All cases of malnutrition or suspected malnutrition continue to receive special attention. Recommendations in respect of free meals and/or milk totalled 98 cases. Of this number 55 were recommended for free dinners, 27 for free milk and 16 for both milk and dinners. PROVISION OF MEALS AND SUPPLY OF MILK. The number of meals (dinners) supplied free of cost for the period 1st January to 31st December, 1941, was 14,852. Similarly, for the corresponding period, 32,979 bottles of milk containing one- third of a pint, were supplied free to children in the schools, excluding Elleray Park Special School. 5 GENERAL REMARKS ON THE EFFECTS OF THE WAR ON THE PHYSICAL AND MENTAL WELFARE OF THE SCHOOL CHILDREN. There is nothing further of importance to add to the remarks made in last year’s Report regarding this matter, except that, as anticipated, Scabies has shown a considerable increase. To meet this emergency, a general survey of the school children throughout the Borough was carried out, resulting in the establish¬ ment of a special clinic in May, 1941, at the New Street Welfare Centre. 193 cases were dealt with, all of which have been satisfactorily discharged, with the exception of 14 cases carried over to January, 1942. Apart from the prevalence of Diphtheria in the fourth quarter, there has been no undue incidence of infectious diseases during the year, and the standard of health generally has been maintained. EVACUATION. Owing to the heavy bombing raids carried out on the Borough in the late December of 1940 and the middle of March, 1941, extensive evacuation took place this year. Approximately 3,552 school children were medically examined and sent to Reception Areas during the twelve months, the first four months being a particularly strenuous time. REPORT OF Dr. T. HARTLEY MARTIN, Orthopaedic Surgeon. 15 sessions have been held at New Street Clinic, at which 49 New Cases have been seen and 208 Re-examinations made (an average of 7 cases per session). These cases are further elaborated as follows : — New Cases : Non-Tuberculous Tuberculous . . Re-examinations : N on-T uberculous Tuberculous . . In relation to School Age. U nder Of Over 29 18 — — 2 — 72 119 10 6 1 In Table 1 (appended) the cases are shown classified in age groups and disease categories : the number of cases discharged is also shown, with the reason for discharge. Of the 246 cases which have been on the Clinic Register during the past year, 4 or 1.5 per cent, have been admitted to the Children’s Hospital, Leasowe, for treatment. 6 These cases were as follows : — Congenital Deformities 2 Cases. Stay in Hospital . . 293 days. Acquired . . . . 1 Case. „ „ . . 38 „ Rickets 1 „ „ „ 238 „ The total number of days spent in hospital was 469 (87.6 per cent, being devoted to children under school age), which is equivalent to 1.3 beds being occupied throughout the year. Of the 4 cases, 1 or 25 per cent., was of school age. The work of Massage and Remedial Exercises Department is of the greatest value in preventive and curative work. During the past twelve months 2,107 treatments have been given to 80 cases on the register. 20 New Cases were admitted and 40 discharged. Table II shows the cases analysed in age and disease groups, and also shows the relative amount of work devoted to children of school and pre-school age. The work of the Clinic has been totally disorganised by the war and the evacuation of school children. It is fortunate that more delicate children are still catered for at Elleray Park Special School and at Rigby House, Parkgate. Parents still resident in Wallasey bring their children willingly to the Clinic, but think it is permissible to wonder as to what is happening to the evacuees. Visits by Surgeon . . . . . . . . 15 Attendances by Orthopaedic Sister . . . . 50 New Cases Examined . . . . . . . . . . 49 Re-examinations.. .. .. .. .. .. 208 Analysis of Cases. Under School Of School Over School Age. Age. Age. Boys. Girls. Boys. Girls. Boys. Girls. New Cases. Non-Tuberculous .. 14 15 11 7 — — Tuberculous • 4 — 2 — — — Re-exa mi natio n s . Non-Tuberculous .. 38 34 76 43 6 4 Tuberculous — — 5 l — 1 7 Massage and Remedial Exercises Department. Boys. Girls. Total. Number of Patients Treated . 42 38 80 Do. Attendances of Cases ... 1359 748 2107 Do. New Cases Referred for Treat¬ ment . 12 8 20 Do. Cases in which the Treatment has been Terminated ... . 18 22 40 Bi-monthly clinics have been held at Oakenholt Road Clinic, at which 17 new cases were seen and 83 re-examinations were made. In greater detail these cases are : — In relation to School Age. Under Of Over New Cases : Non-Tuberculous 1 10 — Tuberculous — — — Re-examinations : Non-Tuberculous 27 46 1 Tuberculous.. 1 8 — Table 1 shows the cases arranged in disease categories and age groups. The number of cases discharged and the reasons for dis¬ charge are also given. Of the 62 Non-Tuberculous Cases on the register 2 cases of school age have been admitted to Hospital : stay, 132 and 321 days respectively. The Massage and Remedial Exercise work is still undertaken at the Leasowe Hospital. 112 treatments have been given to 5 cases. One new case lias been referred for treatment. It is still felt that if the Massage Services could be given at the Clinic, a greater number of children would attend more regularly for treatment. Visits by Surgeon . . . . . . . . . . 5 Attendances by Orthopaedic Sister . . . . . . 7 New Cases Examined . . . . . . . . . . 17 Re-examinations . . . . . . . . . , 83 Analysis of Cases. Under School Age. Boys Girls Of School Age. Boys Girls Over School Age. Boys Girls New Cases — Non-Tuber- culous 4 3 7 3 — — Tuberculous . . — — — — — — Re-examinations — Non- Tuberculous 16 11 32 14 — 1 • Tuberculous . . — 1 — 8 , _ Massage and Remedial Exercises Department. Boys Girls Total Number of Patients Treated 4 1 5 do. Attendances of Cases ... 65 47 112 do. New Cases Referred for Treatment 1 1 do . Cases in which the T reat- ment has been Terminated 9 New Street Orthopaedic Clinic. TABLE 1. Remaining New cases Remaining Discharged, 1941. Disease Categories. 1940. In relation to School age. 1941. In relation to School age. 1941. In relation to School age. 0> M TJ © > © • ^ 2 ver Age — Relieved. eft District. >3 £ © © s 00 -4~> 3 c3 0) £ © 2 cS .■a £ § Died. Under ot Over Under Of Ov er Under Of Over o Ph O HI 03 EH P Infantile Paralysis .. 2 8 1 — — 10 — 1 — _ Spastic Paralysis . . . 2 9 1 2 — — 4 8 — — 1 1 — — — Rickets . Tuber* / Osteitis & 9 2 4 3 4 i culous \ Arthritis — 3 — 2 — — 5 — — — — — — — — ; Non-Tubercul’s do. . Deformities — — 5 5 Congenital . | Deformities — 17 25 ' 3 1 " 1 16 25 ' 3 1 1 ■ ' Acquired . 57 47 — 14 14 — 57 65 — 7 1 1 1 — — — Diagnosis . 9 1 10 2 9 3 10 Totals . 96 100 1 29 20 — 90 124 — 14 3 4 1 — 10 — MASSAGE RETURN. TABLE 2. Attendances. Cases. Of School age Disease Categories. •nf&ntile Paralysis | 'paatic Paralysis .. .. tickets J. ® — Osteitis and Arthritis JW-TB.— Do. °ngenital Deformities • paired Deformities Totals Totals . . Percentages . . Education for Tonsils and A<*enoids. . Boys o o © CO bf) a • H £ © < bG B Ti c c 2 s-5 * “ O £ bD .5 £ © o © CO 109 7: 121 39 52 — 173 — j 56 Girls o o XI o CO bC .3 T3 £ 2 b 0 £ • H T3 £ o s o «3 © ^CO o SZ5 25 — bo O £ 2 ^ © £ M CX, CO 40 26 Under School Age. GQ >. o W i2 .ta O Over School Age. 00 o PQ 00 r— * lH • r-« o CO 0) a © s-< o © X B p 52? a a © •»> o o S.O 42 13 333 51 201 105 35 88 19 207 850 371 270 230 107 22 43 1704 83-7% 60 — — 581 — 343 16 3% 0/ /o 6 7-5 8-75 % 1-25% 1*25% 27-5 % 46-25% 10 BiT tr 10 Oakenholt Road Orthopaedic Clinic. TABLE 1. Remaining New Cases Remaining Discharged, 1941 • Disease Categories. 1940. In relation to School age. 1941. In relation to School age. 1941. In relation to School age. T3 0) H H3 0) > <0 o ver age — relieved. Left District. c 0J TJ g 3 a u-i O 03 Lh ja; 2 $ • H D a i Under Of Over Under Of Over Under Of Over o O Ch h D Q Infantile Paralysis — 1 — _ _ . 1 ___ ____ i __ _ Spastic Paralysis . . l 1 3 — — — — 1 3 — Rickets Tuber-/ Osteitis & l culous \ Arthritis . . l 4 — — 1 — 1 4 — _____ 1 — — — — _ Non-Tuberculous do. Deformities — — 3 — “ " ’ " — 1 1 _ — 1 — Congenital . . Deformities — 6 6 — ~ 2 5 3 2 — — — — Acquired 5 12 — 4 5 j 6 15 — 5 — — — — — Diagnosis 1 1 — 3 i 4 ~ ' 2 1 — 6 — Totals • • • . 15 29 " 1 7 10 — 13 29 2 8 3 — 1 • 7 — MASSAGE RETURN. TABLE 2. Disease Categories. Attendances. Cases. Of School Age. Under School 0 Set ver 100I Number of cases. % of total c&see. Boys Girli i Age. A| j Attending School. Not attending School. Attending Special School. Attending School. Not attending School. Attending Special School. Boys. Girls. Boys. Girls. Infantile Paralysis . 1 Spastic Paralysis . — — — — — 47 — — 1 20 °/ Rickets . T.B. — Osteitis and Arthritis — 1 — — Non-T.B. — do. . — — — Congenital Deformities . 3 — — 33 — — _ 3 60 Acquired Deformities . 1 29 1 20 °/ Totals . 3 — ^ .r— ' | G2 47 — — — — Total® . 3 109 Percentages . 2*7% 97- oo/ ° 0 11 REPORT ON THE WORK OF THE REMEDIAL SPEECH¬ TRAINING CLASSES. MISS BARBARA BARTON. In December, 1940, 34 children were in attendance at the Remedial Speech-Training Classes. 18 children attended at the Technical School Centre, Church Street, and 16 children attended at Eastway School Centre, Moreton. Of these children, 18 were cases yy y y 5 y ) y ) of stammering, word blindness, idioglossia. dyslalia, defective single consonants. The Technical School Centre was destroyed by enemy action in March, 1941. After the subsequent evacuation of school children, only 6 of the children attending this Centre remained at school locally ; and no further provision was made for treatment for these cases. The Eastway Centre consists of two classes, one for stammerers and one for articulatory defects. Of the 16 children on the register in December, 1940 : — 7 have been discharged as no longer needing treatment, 3 have left the district, 6 are still in attendance. Elleray Park Special School. No. of Children on the Register, January 1st, 1941. Boys 36. Girls 28. Total 64. Removed from the Register during the year — 20 Valvular Disease Heart . . . . . . 1 Infantile Paralysis . . . . . . 2 Spastic Paralysis . . . . . . 5 Asthma . . . . . . . . . . 1 Bronchitis . . . . . . . . . . 1 T.B. Spine . . . . . . . . . . 1 Hip Disease . . . . . . . . 1 Malnutrition . . . . . . . . 8 Admitted during the year —10. No. of Children on the Register, December 31st, 1941. — Boys 30. Girls 24. Total 54. 12 Classified as follows : — Boyi Spastic Paralysis . . . . 2 Infantile Paralysis . . . . 1 Asthma . . . . . . 4 Congenital Heart . . . . 2 Valvular Disease Heart . . 3 Rheumatism . . . . 2 Chorea . 1 Bronchitis . . . . . . 1 Tuberculosis Spine . . . . 0 ,, Peritoneum . . 1 Defective Bone Formation . . 1 Nephritis . . . . . . 0 Malnutrition . . . . . . 9 Bronchiectasis . . . . 0 Not Diagnosed . . . . 2 Talipes . . . . . . 1 Girls 1 0 2 1 3 0 2 0 1 0 0 1 9 1 3 0 As the majority of the children were evacuated on the 1st February, the usual monthly visit of the Medical Officer was dis¬ continued, but inspections of those remaining were carried out in June and October. Medical Records Cards. Only 14 applications were received during 1941 from Medical Practitioners under the National Health Insurance (Juvenile Contri¬ butors and Young Persons) Act, 1937, for confidential information to be obtained from the School Medical Records. Of this number, information respecting 6 boys and 8 girls was returned. Children Medically Examined for Employment Cards, 1941. Delivering Newspapers . . . . . . 123 Delivering Milk . . . . . . . . 24 Total . . 147 (Children who are employed after School hours only are not medically examined, Entertainment Licences excepted). Children medically examined for Entertainment Licences total 4. 13 LIVERPOOL AND DISTRICT CHILD GUIDANCE CLINIC (up to 31st July, 1941, when the Clinic was closed). The School Medical Officer is indebted to the Honorary Chief Psychiatrist for his report on the Wallasey cases dealt with during 1941, and of which the following is a brief summary : — - New Cases, 4. Referred by Medical Officer of Health 1 „ Hospitals . . . . . . 1 „ Head Mistress . . . . 1 ,, Billeting Officer . . . . 1 In addition 3 cases were carried forward from 1940. The conditions for which advice was sought were as follows : — Unsatisfactory Nervous Stammering Behavious Behaviour Backwardness New Cases 1 2 1 — Old Cases 1 1 1 — Of the 4 New Cases referred during the period the Clinic was open, 1 was found unsuitable (advice being given to the Matron of the Hospital and the Billeting Officer), 1 was passed on to the Liverpool Psychaitric Clinic, and the remaining 2 had their treatment terminated with the closure of the Clinic on the 31st July, 1941. In the 2 latter cases, the final reports were “ much improved ” and “ improved ” respectively. The three cases brought forward from 1940 were finally concluded as follows : — - Treatment discontinued at parent’s request in 1 case ; inability to trace the family in another ; the third was terminated with treat¬ ment incomplete owing to the closure of the Clinic. REPORT OF THE SENIOR SCHOOL DENTAL OFFICER. The Clinic premises were seriously damaged in March, but we were very lucky to lose little of our irreplaceable equipment — a few bottles and the older of the two dental engines being destroyed. The rest of the equipment was salvaged by the dental staff, transferred for a time to Moreton, thence to a house in Liscard Village, where an emergency Clinic was set up within fourteen days. This has gradually turned into a permanent centre. A single large room placed at our disposal was divided into two, each half being fitted up as a Dental Surgery, complete with electrical and other fittings. Only one is in use as a Surgery at the moment, the other room being used as a waiting room. There is no recovery room, and we are compelled to use the waiting room also as a recovery room when we are extracting teeth under a general anaesthetic — a most unsuitable and objectionable arrangement. 14 The need for Dental Service in the local evacuation area has gradually become less, as children left school or drifted home, and the original five half-days devoted to that work has been reduced to a single half-day per week — Moorland House School and Rigby House Special School being visited as occasion requires. The Cheshire County Council has taken over the few other Wallasey children scattered in the Wirral area. Now that things are stabilised, at any rate for a time, there is more than enough work for one dentist in the Wallasey school area. Difficulty has arisen due to the fact that for many years practically all extractions have been done under nitrous oxide gas, and parents and children have become used to it. It is indeed in our opinion the only really suitable method of extracting teeth for children with the minimum of discomfort. It was a simple matter with three dentists on the spot to give gas promptly and often, but not so easy for a single operator. An Anaesthetist visits the Clinic twice per week, and as many cases as possible are done during his visit, but there are many more needing attention than can be dealt with in two sessions. The School Dentist, assisted by his two nurses, treats single-handed as Anaesthetist and Operator suitable cases, but this practice will have to cease when the nurse due to leave joins the Forces. Routine examinations and treatments have been hopelessly disorganised by the war, but attempt is being made to keep them up as far as possible. A good deal more time is being spent extracting than in normal times, particularly for the relief of pain. The shortage of dentists in private practice in Wallasey is becoming noticeable, and as more and more join the Forces the School Dental Clinic is likely to become a more and more important public service. WALLASEY EDUCATION COMMITTEE. MEDICAL INSPECTION, 1941. Elementary Schools. TABLE I. RETURN OF MEDICAL INSPECTIONS. (A) ROUTINE MEDICAL INSPECTIONS. Number of Inspections in the prescribed Groups: Entrants ... ... ... ... ... ... Intermediates Leavers ... ... ... ... ,,, Total Number of other Routine Inspections . (B) OTHER INSPECTIONS. Number of Special Inspections and Re-Inspections . *609 * Does not include employment cases. 670 666 534 ... 1870 16 TABLE II. (B) Classification of the Nutrition of Children Inspected during the year in the Routine Age Groups. Number of Children Inspected A (Excellent) B (Normal) C (Slightly Subnormal) D (Bad) No. 0/ /o No. 0/ /o No. 0/ /o No. 0/ /o 1870 277 14.81 1559 83.37 33 1.77 1 .05 TABLE III.— TREATMENT OF DEFECTS OF CHILDREN DURING 1941. Group I.— TREATMENT OF MINOR AILMENTS. (Excluding Uncleanliness, for which see Table V.) Disease or Defect. Number of Defects Treated. Under Local Education Authority’s Scheme Otherwise Total Skin — * Ringworm — Scalp . 4 (-) (-)- 4 Body . 2 2 4 Scabies ••• ••• ••• ••• 268 5 273 Impetigo . 190 4 194 Other Skin Diseases . 130 2 132 Minor Eye Defects (External & other) 91 3 94 Minor Ear Defects (Otorrhoea) ... 60 — 60 Miscellaneous . 805 70 875 Total ... 1550 86 1636 * No X Ray cases as shewn in brackets. 17 GROUP II.— DEFECTIVE VISION AND SQUINT. (Excluding Minor Eye Defects treated as Minor Ailments — Group I). Errors of Refraction (including squint)— No. of Defects dealt with — Under the Authority’s Scheme ... ... ... 168* Otherwise ... ... ... ... ... ... — - 168* Other Defect or Disease of the Eyes (excluding those recorded in Group I) — Under the Authority’s Scheme ... ... ... — By Private Practitioner or at Hospital, apart from the Authority’s Scheme ... ... — Otherwise ... ... ... ... ... — * Includes 8 Secondary School cases. Mo. of Children for whom spectacles were — Prescribed — Under the Authority’s Scheme ... Otherwise ... - Obtained — Under the Authority’s Scheme ... Otherwise ... f Includes 7 Secondary School cases. 168* 1 54 f 154f Group III.— TREATMENT OF DEFECTS OF NOSE AND THROAT. Received Operative Treatment — (i) (ii) Under the Authority’s Scheme, in Clinic or Hospital ... ... ... ... ... 2 4 By Private Practitioner or Hospital, apart from the Authority’s Scheme ... ... — — (hi) (iv) 34 — Total ... 4 34 Received other forms of Treatment . . Total number treated . . (i) Tonsils only. (ii) Adenoids only. (iii) Tonsils and Adenoids. (iv) Other defects of the Nose and Throat. 18 Group IV.— ORTHOPAEDIC AND POSTURAL DEFECTS. Under the Authority’s Scheme. Otherwise. (1) (2) Residen- Residen- Non- Residen- Residen- Non- Total tial tial residen- tial tial residen- number treat- treat- tial treat- treat- tial treated. ment ment treat- ment ment treat- with without ment with without ment educa- educa- at an educa- educa- at an tion tion ortho- tion tion ortho- paedic paedic Clinic Clinic . (i) (ii) (iii) (i) (ii) (iii) Number of children treated 4 — 58 — 62 TABLE IV. Group IV.— TREATMENT OF DENTAL DEFECTS. NUMBER OF CHILDREN DEALT WITH DURING 1941. Inspected by Dentist — Routine Age Groups. ♦Specials ... Age 5 years ... ... 140 „ 6 „ . ... 205 n 7 t / ... 288 ,, 8 „ ... 357 „ 9 „ . ... 393 J „ io „ . ... 394 1 ..a „ . ... 345 12 . . ... 351 ,, 13 ,, ... ... ... 387 „ 14 . ... 227 .,15 . 49 „ 16 „ and over 5 " Total 3134 678 Grand Total ... 3812 Referred for Treatment ♦Specials Actually Treated ♦Specials ... 2157 ... 678 1307 678 2835 1985 ♦ Includes 92 cases from the Secondary Schools. 19 TABLE IV. — Continued. PARTICULARS OF TIME GIVEN AND OF OPERATIONS UNDERTAKEN. SCHOOL DENTIST’S REPORT FOR THE YEAR 1941. Number of half days devoted to Inspection 37 Number of half-days devoted to Treatment... 825 d otal ... ... 862 Total number of attendances made by Children for treatment 2783 t (92) Number of Permanent Teeth — Extracted ... ... ... ... ... ... 746 (52) Filled • ••• ••• • • • ••• ••• i 930 (138) Number of Temporary Teeth — Extracted ... 1823 (4) Filled ••• • • • ••• ••• 7 (-) Total number of Fillings . 937 (138) Total number of Extractions 2569 (56) *Number of administrations of general anaesthetics ... 1185 (34) Number of Other Operations — Permanent 503 (46) Temporary . — (-) ^Nitrous Oxide. t Figures in brackets denote Secondary School Statistics included in first total. Particulars of Work carried out during 1941 by the School Dentist for Wallasey Children in the Reception Area to which they have been evacuated. No. of Sessions for treatment ... 73 "] „ „ Inspection . 6 J Children attending for Inspection or Treatment ... Children treated . Children refusing Treatment or impossible to treat... Number of permanent teeth filled ... Other operations on permanent teeth . Number of temporary teeth extracted Number of permanent teeth extracted Total 79 779 369 20 115 54 279 46 TABLE V. UNCLEANLINESS AND VERMINOUS CONDITIONS. (1) Average number of Visits per School made during the year by the School Nurses ... ... ... ... 9-75 (2) Total number of Examinations of Children in the Schools by School Nurses ... ... ... ... 13,151 (3) Number of individual Children found unclean ... 313 (4) Number of Children cleansed under arrangements made by the Education Authority ... ... ... — 0 (5) Number of cases in which legal proceedings were taken — (a) Under the Education Act, 1921 ... ... — (b) Under School Attendance Byelaws ... ... — MENTALLY DEFECTIVE CHILDREN. / Total number of Children notified during the year ended 31st December, 1941, by the Local Education Authority to the Local Mental Deficiency Authority under the Mental Deficiency (Notification of Children) Regulations, 1928 . 3. 21 MEDICAL INSPECTION, 1941. Secondary Schools. TABLE I. RETURN OF MEDICAL INSPECTIONS. (A) ROUTINE MEDICAL INSPECTIONS. Age Groups. Boys. Girls. Total. Entrants Under 12 62 88 150 ( 12 . 80 53 ) Intermediates <13 76 78 V 389 14 72 30 J T { 15 ... ... Leavers { r\ . - 1 Over lo 97 20 30 1 J- 148 Totals ... ... ... 407 280 687 Number of other Routine Inspections ... (B) OTHER INSPECTIONS. Number of Special Inspections and Re-Inspections ... ... 1 TABLE II. (B) Classification of the Nutrition of Children Inspected during the year in the Routine Age Groups. Number of Children Inspected A (Excellent) B (Normal) c (Slightly Subnormal) D (Bad) No. 0/ /o No. % No. 0/ /o No. 0/ /o 687 202 29.4 463 67.4 22 3.2 — — .