Meltham UDC: Annual Report of the Medical Officer of Health (1960) by Eric Ward

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URBAN DISTRICT OF MELTHAM

ANNUAL REPORT

OF--PHE

Officer of Health for the Year

BY

ERIC WARD

NEE.C..S., vb RG

GREEN & CO. (Printers). LTD. I SLAITHWAITE-

1961

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Meltham Urban District

LIST OF COUNCILLORS

FOR THE YEAR 1960/61

Chairman:

H. BASTOW, Esq., J.P.

Vice-Chairman:

J. STEEL, Esq.

R. C. ASHTON, Esa. *J. W. HOLLINGWORTH, F. E. DAWSON, Esc. Mrs. J. R. KIRBY, J.P. tid H. B. DEARNLEY, Esq. E. V. QUARMBY, Esq., J.-P. H. FISHER, Esq. H. STEAD, Esq. H. HIRST, Esq. E. TAYLOR, Esq.

* Chairman of the Public Health Committee

The Public Health Committee is composed of all the members of the Council

PUBLIC HEALTH OFFICERS OF THE COUNCIL Medical Officer of Health:

ERIC WARD, M.R.C.S., L.R.C.P., D.P.H.

Deputy Medical Officer of Health:

L..M.: B..ROHAN, MB. 1B. CH. GoD. Pe (Resigned 30-4-60)

DS, PICKUrT. Ate. 6.644 D225 (Appointed 1-6-60) Public Health Inspector: N. SYKES, M.A.P.H.I.

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Divisional Health Office, Woodville, Scam Lane, GOLCAR, nr. Huddersfield. July, 1961.

To the Chairman and Members of the Meltham Urban District Council.

Mr. Chairman, Lady and Gentlemen,

I have the honour to present to you my fourteenth Annual Report on the Health of the Meltham Urban District and the work of the Public Health Department in 1960.

As in previous years the sections of the Report dealing with the Sanitary Circumstances, Housing and Food have been compiled by your Public Health Inspector and form his Annual Report for the year.

The most interesting item from the year’s vital statistics is the Registrar General’s estimate of the population of the District at mid-1960 which was 5,290, or 100 above the figure for the previous year. As the population has been more or less static for a number of years at about 5,150, this relatively large increase is worthy of particular mention.

With the completion of the Helme and Wilshaw sewerage schemes and the reconstruction of the sewage works in the previous year, 1960 has been one of consolidation rather than one of promotion of new projects. The new sewers have enabled an increased number of houses to be provided with water carriage sewage systems. In this connection it is interesting to note that at the end of the year the number of pail closets in use was 63 and the number of privies, 33, whilst in 1950 the figures were — pail closets 155, privies 131. It is reasonable to expect that a further substantial number of these atrocities will disappear in 1961.

The Council’s programme for dealing with unsatisfactory houses is still some three years in advance of the Schedule prepared in 1955, hence the limited action taken in this connection during 1960.

As is customary, details are given in Section VII of the Report of the Services provided by the West Riding County Council as the Local Health and Education Authority.

Once again I must conclude this introduction by thanking you, Mr. Chairman, and members of the Council for the keen interest you take in the work of the department and to express my appreciation for the assistance and co-operation received from your Clerk and the other Officers of the Council. In particular my thanks are due to your Public Health Inspector, Mr. N. Sykes, for his unceasing help and loyal co-operation. ] have the honour to be

Your Obedient Servant, ERIC WARD, Medical Officer of Health.

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and

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I

STATISTICS AND SOCIAL CONDITIONS

The Urban District is situated on high ground about five miles to the south-west of Huddersfield, the principal centre of population being the township of Meltham, whilst other hamlets in the District are Meltham Mills, Helme and Wilshaw.

High moorland rising to a height of over 1,500 feet forms the western and southern parts of the District. The principal industries now carried out in the area are engineering, including tractor building, woollen textiles, silk dressing, brick and tile making and mixed farming.

General Statistics

Area in acres ro: or ory ese Oe one ye 5,906 Enumerated Population (Census, 1931) ... aes Be a 5,051 Enumerated Population (Census, 1951) ... ae we ae 5,107

Registrar-General’s Estimate of Population (middle of 1959) 5,190 Registrar-General’s Estimate of Population (middle of 1960) 5,290

Area Comparability Factors: oa i Births 1.04; Deaths 1.00 Number of Inhabited Houses at end of 1960 ... Xt ee 1,998 Rateable Value (31st March, 1961) un ox. a. ... £61,430 Sum represented by a Penny Rate (March, 1961 if. B £245

Vital Statistics

Live Births MELTHAM URBAN DISTRICT Birth Rate per 1,000 §. 24 so ee ee I ele eae Population Total number (after per 1,000 = |—————__ ioe Rc adjustment for t ransfers) population — —— West Riding of I England} I Sex I Illegitimate Yorkshire I and Year Total ——-—|——-— — ee —-| Wales

F I No. % I Crude} Adjt. I U.D’s |Adm.Cty

1960 «78 41/37) 3 I 3-85 I 1474] 15-33) 16.7 I 17-1 I IT 1959, 69/39/30; 1 I 1.45 I 13.29] 13.82] 162] 16.7 |. 165 font |p] 4b ead Mea I itor tes ee ie I I

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Still Births

1960 1959 1958 Legitimate os oF oi “ae “2ohembelte arate 1 male Illegitimate... ee a fae Nil Nil Nil Stillbirth Rate per 1,000 live and stillbirths 25.00 14.29 13.33

Infant Mortality — Deaths of Infants under 1 Year

INFANT DEATHS RATES PER 1,000 LIVE BIRTHS } MELTHAM URBAN DISTRICT West Riding of ———— ] ———_ I — —|—--- I Yorkshire England Sex Illegit- I Meltham ———-_—_—_{ nae and Year I Total |}—— imate U.D.. I I >. Wales e060 = 38-46 I 22.5 25 Or # 1959 — —_ — — — 24.0 24-0 22.0 1958 3 3 o— —— 40-54 I Zorn 24-4 22:5 Deaths MELTHAM URBAN DISTRICT WEST RIDING OF I ENGLAND I -~ ee ee YORKSHIRE AND Total Deaths (after WALES adjustment for Death Rates ———— —— transters) per 1,000 Death Rate per rs — population 1,000 population Death Rate I I Sex per 1,000 Year I Total laa ee ee ——| population i Crude Adjt. LUDisi Adm. Cty. 1960 I 68 35 33| 12-85 12.85 12.9 02 1959 54 I 23 31 10.40 10-40 43.0 1244 14:6

1958 63 I 41 22 12-26 12-26 13-3 13-0 1457

The chief causes of death were:—

1960 1959 (1) Diseases of the heart and circulatory system a7 25 (ii) Malignant Neoplasms ny ae .3. 8 10 (111) Intra-cranial Vascular Lesions 8 9

In 1960 these three causes accounted for 63.24% of the total deaths, 39 or 57.35% occurred in persons 65 years or over and 28 or 41.18% in persons 75 years or over.

A table showing the causes of death, ages and sex distribution is set out on page 5. No deaths occurred from the following causes:—

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R.G. List Cause R.G. List Cause

No. No. 2 Tuberculosis, other 16 Diabetes 3 Syphilitic disease 22 Influenza 4 Diptheria 25 Other diseases of respira- 5 Whooping Cough tory system 6 Meningococcal infections 26 Ulcer of stomach and 7 Acute Poliomyelitis ‘ duodenum 8 Measles 28 Nephritis and nephrosis 9 Other infective and para-- 29 Hyperplasia of prostate sitic diseases 30 Pregnancy, childbirth, 10 Malignant Neoplasm — abortion stomach 33. Motor vehicle accidents 13. Malignant Neoplasm — 36 Homicide and operations uterus of war

Maternal Mortality

No deaths were registered as directly due to pregnancy and child- bearing. Cancer

The number of deaths attributable to Cancer during the year num- pered 8 (4 males and 4 females) as compared with 10 in 1959.

AND I I I I Causes of Death Sex Ages 1-| 2 5-15 25-|35- 45- I I I a ee ee Sie eee eee ees ee eee All Causes a me AR a Ip I NI Pe 13 I 3 I 3 [15 Pegg Pushes ba lh pep yt! Baa 1 Tuberculosis Respiratory I M ] I es 1 1? neoplasm =) My) 2.2) fa) 2) le Pes Ines, bronchus +... cick I cea I 12 Malignant neoplasm — I M_ .... ae pet ee. breast... we MOTI FOUL I 1 Ofeer. mabedant and 2) 2 ee a cee I l lvmphatic neoplasms ... |F I 1 I ares I be l 15 Leukaemia Aleukaemia|M)| 1 foe 1 2 ee 17 Vascular lesions of ner-|M/ 3 I rh vous system ALC. 5 ES BES b bet Bi ee 18 Coronary disease, angina I M/ 11 Lo. I {aS fae F) 2 wise ele allah 1 19 Hypertension with heart |M) 1 hace oe 1 disdase: 4 98... Be OP es oe feed ou 20 Other heart disease 4 I te 4 IF I 6 ares 5 21 Other circulatory disease.) Nui 1 I opp ie... 3 eet eee bee te fe 9 I I pS I a 28 den “eer ee I et J = win) Mies. =: eed 24 Bronchitied A HELE AO I SIT el 3 I B|4 Borie a We shal pane bf 27 Gastritis, enteritis, and I M ne ics ea I sla 3 diarrhoea we Tea { ene pla 31 Congenital malforma- I M I covert tions ard cr ee I ZA I ae eee aoe i 32 Other defined and ill-|M, 4) 1 de hae eco defined diseases ... ...|/F . 6| 1 1 bite 1 q|4 34 All other accidents ...|M 2% a 1 1 I (12 I Patt 35 Suicide I I 1 WE seo 1

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SECTION. 4: GENERAL PROVISION OF HEALTH SERVICES FOR THE AREA

Staff

There is no change in the arrangements as detailed in previous re- ports.

Laboratory Facilities These remain unchanged. Ambulance Service For accident and general cases this is provided by the West Riding County Council. Infectious cases are removed by the ambulance of the Infectious Diseases Hospital to which the patient is removed.

Home Nursing and Midwifery

A Home Nurse/Midwife employed by the County Council is resident in Meltham.

Treatment Centres and Clinics

Infant Welfare Clinic - Baptist School Tuesday afternoon. Venereal Diseases Clinic - Huddersfield Royal Infirmary.

Hospitals: (a) Infectious Diseases: Mill Hill Isolation Hospital, Huddersfield. (b) General Hospitals: St. Luke’s Hospital and Royal Infirmary, Huddersfield; Holme Valley Memorial and Deanhouse Hospital, Holmfirth. (c) Maternity: Princess Royal Maternity Home; St.

Luke’s Hospital; and Huddersfield Royal Infirmary.

SECTION

SANITARY CIRCUMSTANCES OF THE AREA Mr. N. Sykes, Public Health Inspector, reports:— Water Supply The two undertakings concerned in the supply of water within the Urban District are those of the Meltham Urban District Council and the Huddersfield Corporation. The approximate areas of supply are 5,134 acres by the District Council and 772 acres by the Corporation.

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The Urban District Council’s supply is derived from Fearn Nook Spring, Orleans Spring and Royd Drift and Borehole. The storage cap- acity of the reservoirs is 3,090,000 gallons. A further supply of 80,000 gallons per day is received from Huddersfield Corporation without charge and also Huddersfield will supply a further 20,000 gallons per day at the lowest price charged in the Borough.

The total consumption of water, domestic and trade, was 58,567,000 gallons of which 28,751,000 gallons were derived from the Council’s own supply and 29,816,000 from Huddersfield Corporation. 28,399,000 was supplied free and 1,417,000 supplied at the lowest rate.

The average daily consumption was 160,896 which shows an increase of 9,267 gallons over 1959. The average consumption per head per day, taking a population of 5,000 as a basis, was 32.18 and this includes water supplied for all purposes.

During the year the scheme for providing treated water to the Leygards area was completed satisfactorily and extensions to the mains were carried out at Hebble Mount and Colders Lane to provide for further private development.

No complaints were received during the year regarding water shortage and only one of dirty water. In this case the remedy lay in the hands of the owner.

Sampling was carried out at regular intervals of raw water and treated water, all samples of treated water being satifactory. Samples of water from the public supply were also submitted for plumbo-solvency and were found to be free from lead.

Private Supplies

The number of premises relying on private supplies has been reviewed and found to be only 44. Sampling was carried out at Holthead and Crosland Bank quite regularly. A number of domestic filters have been installed on the Crosland Bank supply and are giving a satisfactory service.

Details of Samples Obtained

Chemical Plumbo Solvency Bacteriological TU , Sat.” iota: ede, Public Supply ... — — 4 — 65 13 with i — — — — 25 21 APR see se — — 4 — 90 34

Drainage and Sewerage

As a result of the recently compieted extensions to sewers at Helme and: Wilshaw a further 30 houses have been connected to the public sewer. The number of houses not connected to the public sewer is 118 and of these 20 can be considered to have satisfactory private drainage.

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The only district not provided with a sewer and which could reasonably be provided is the Red Lane area. This would enable exist- ing property to be modernised and development to take place. The matter is in hand and should mature in the near future. The enlargement and modification of the sewage works was completed in the early part of the new year and officially opened in June.

Closet Accommodation

Further progress has been made in the conversion of pail closets and privy middens. Twenty-one pail closets and 9 privies were converted and one pail closet abolished affecting a total of 33 houses.

At the end of the year work was proceeding on two conversions and plans submitted for converting a further 9 pail closets and one privy.

With similar progress in 1961 it can be expected that practically all possible conversions will have been effected. The number of dwellings having pails or privies as sanitary accomodation is now down to 132. Of this number 106 cannot be provided with water closets.

The number of pail closets in use is 63 and privies 33. Public Cleansing

The collection of house refuse, trade refuse, salvage etc. was put into the hands of a private contractor for a further three years. The contract allows for a weekly collection of refuse from approximately 90% of the district and a fortnightly collection from the remaining 10%.

Generally speaking the service has been satisfactory, very few complaints have been made regarding the frequency of collection.

Much more could be done by the householder in the use of the bin and it has been my experience this year that more complaints have been made by the refuse collectors regarding unhygienic bins than those from householders regarding the frequency of emptying. A visit to the refuse tip by any householder would not be out of place and I feel sure he would go away with a resolution to use his own bin in an intelligent manner.

The tipping at Royd Bridge is controlled as far as possible, one man being employed full-time to deal with the refuse as it arrives.

The use of clinker for covering material has now become a major problem due to the whole output from the Central Electricity Board Power station at Huddersfield being let to one contractor.

The gross cost of the service in 1960 was £4521-17-0 with an income from salvage etc. of £310-0-3 to set against it.

Filthy, Verminous or Unwholesome Premises

No partcular problems have arisen during the year. Two premises were treated for infestations of crickets and one of cockroaches.

_A number of houses, which could not be classed as filthy or verminous, merely dirty, were dealt with informally.

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Shops Acts

There is no particular observation to be made regarding shops, conditions generally being satisfactory. The total number of shops of all types is 57 of which 31 are lock-up shops and the remainder combined with living accommodation.

Smoke Abatement

During the year 127 observations were made of the industrial chimneys in the district. Offences were reported to the Health Commit- tee on two occasions after which letters were sent to the firms concerned.

A number of additional offences were noted with regard to the works under the control of H.M. Alkali Inspector. I am happy to say that the inspector invariably calls in the Health Department when he is in the district and that he shows an interest in the local arrangement whereby a ‘“‘no-smoke’’ bonus is operated for the kiln firers. This means that a certain amount of local control, although unofficial, is retained, and taking into consideration the amount of fuel used and the manner of firing the management deserve credit for their efforts. The weakness of the legislation with regard to continuously fired processes is that there is no provision for smoke emitted during darkness and doubtless, over the country, in such processes as_ brick making, etc. the greater part of the pollution occurs at that time.

The Prevention of Damage by Pests Act, 1949

The work of eradicating rats and mice has carried on unevent- fully throughout the year.

There have been no major infestations of either pest. Public buildings such as schools, and farms have required most attention. 81 visits were made, mostly in the company of the rodent operative, who is employed part-time only in this capacity.

Factories Act, 1937, 1948 and 1959

On the ist December, 1960, the functions of the Urban District Council under Sections 34 and 85 of the 1937 Act became exercisable by the Fire Authority. This Function of certifying that certain factories have sufficient means of escape from fire carries a heavy responsibility and the inspector of a small district, having no second opinion to turn to, has perhaps felt the responsibility more than most.

One must criticise the 1959 Act in that it places the responsibility for certifying that means of escape from fire are provided upon the Fire Authority, the responsibility as to audible means of warning being left with H.M. Inspector of factories. This division of responsi- bility which always existed appears unnecessary.

The general condition with regard to sanitary accommodation have remained satisfactory and only one factory still retains pail closets for use by the work people. It is anticipated that these will be converted in the near future.

The following are the prescribed particulars on the administration of the Acts during 1960.

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1. Inspections for Purposes of Provisions as to Health

No. on Nam be r of Written Occupiers Premises Register Inspections Notices Prosecuted

(i) Factories in which Sections 1, 2, 3, 4 & 6 are to be enforced by Local, Authorities just =. 1 1 — — (ii) Factories not iméluded’ in (i) in which Section 7 is enforced by ‘the Local Authority. 2-2. 32 10 —~ — (iii) Other premises in which Sec- tion 7 is enforced by the Local Authority (excluding out- workers’ Gin. 8: 3 2 — —

a a A

2. Cases in which Defects were found

¥

Re f-ex ted toH.M. by H.M. Particulars Found Remedied insp. Insp. Prosecuted

Want of Cleanliness... ——- — — Overcrowding LASS: — — a 4. Unreasonable temperature — — — =e ms Inadequate ventilation ... — — p22 2 Ineffective drainage of She. kis ais — a — aos Sanitary Conveniences (a) Insufficient ee — — — a zi. (b) Unsuitable or de- fective re. eg — 1 — — BE (c) Not separate for Sexes: iy. U2POGr. — = — ae Other offences against the Act (not including of- fences relating to Out- work) eet... « — a cee ay.

TOT AL. — 1 — ae Sis

3. Outworkers

There is one outworker in the district engaged in the making of wearing apparel.

Schools — Sanitary Accommodation

Meltham Mills School, which was reported last year as needing a complete new installation, did in fact have the necessary work carried out. There is no doubt that the improvements have made a large cont- ribution to the comfort and welfare of the pupils attending this school. No work has been commenced at Wilshaw School on the conversion of the pail closets there but it is expected that by the end of 1961 these, also, will have been abolished.

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By the time the new school is completed in Meltham the sanitary accommodation in all the schools will be on the water carriage system and all but Meltham Mills will be accessible under cover.

Sanitary Inspection of the Area

Again figures giving the different types of work involved are included. These figures cannot be considered important and, on average, vary little from year to year.

Meat Inspection Tenancy applications Me (27 Food vq 4246 a1 60 Pactomes (ers ore. a4. follaes: 10 inatS and Mice .sper. sce Sh Sr ae a ae ee TO Hairdressers 3 Milk and Dairies Regula PUBLIC HEALTH ACT fons A} ary os Complainis ... ... ... 1944 Ice Cream premises on 19 Reviits ofan! Petroleum Acts and Regula Unwholesome premises 8 tions ve ree ee ee TD Infectious Diseages ek FF Wiscellaneous (oy 25 Dwellings A CUNO Saco Sak I latin. dete Conversions oi) C210. 288 CLEAN AIR ACT HOUSING ACTS OSCR OM Gat dn pee oth cud, Tak cryin: (26 Interviews Sno pte oA ok) 189 Refuse Disposal vo Zol

= St Oa 8 8 LAY Mr. N. Sykes, Public Health Inspector, reports:—

HOUSING

The total number of new houses completed during 1960 was 43, 28 being Council houses and 15 erected by private enterprise.

In addition there were 25 applications for discretionary or standard erants, all being approved.

Overcrowding

There is no record of overcrowding in the district.

Housing Statistics

Perusal of the statistics given below show very little activity in the housing field. Indeed the only action that has been taken is that of dealing with houses which became vacant through re-housing of the tenants.

Since 1955 some 77 houses have been demolished, 47 closed and not re-occupied and 32 were closed but which have subsequently been improved and used again as dwelling houses. This gives a_ total of 156 houses in the five years which explains the slowing down over fhe final year in order to keep pace with the schedule prepared in 1955.

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(1) Number of houses represented as being unfit for human

habitation (a) in Clearance Areas ae Ae fa (b) individual unfit houses aE ae 11

(2) Houses demolished in Clearance Areas as unfit for human habitation ae ms Ja] Oy. J id 7

(3) Houses not in Clearance Areas demolished as a result of formal or informal action under Section 17(1), Housing INCL, ~ FOOT on a ie ots ae ae on 3

(4) (a) Unfit houses closed under Sections 16(4), 17(1) and

1957 7 (b) Number of families displaced from these houses ti 2. (c) Number of persons displaced from these houses ik: 5 (5) Unfit houses made fit and houses in which defects were remedied (a) After informal action by the local authority:— (1) by owners es me ae Rs: ses 6 (11) by local authorit ny. “ise the as (b) After formal notice under Public Health Acts (i) by owner oa to sige mes ia 1 (i) by local authorit me ee ee vee ie 1 (c) Atter formal notice under Sections 9 and 16, Housing Act, 1957 (i) by owner ba oe i ae Me 6 (1) by local authorit ae Bi ee s.r aU (6) Number of families re-housed during the year in to Council owned dwellings from Clearance Areas (etc.) ee i 3

(7) Rent Act, 1957. No certificates of disrepair were granted and none were cancelled.

SECTION V

Mr. N. Sykes, Public Health Inspector, reports:— INSPECTION AND SUPERVISION OF FOOD Milk Supply On the 28th November, 1960 the Urban District was included in an area specified as one in which only designated milk could be sold. As pointed out in previous reports this has not altered the situation

as far as Meltham is concerned because of the fact that non-designated milk has been sold in the district for a number of years.

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The end of the year also saw the handing over to the food and drugs authority the responsibility for the licensing of dealers in designated milks. The manner of licensing has always been rather cumbersome and unnecessarily complicated and any effort to streamline the system is bound to have a good effect. The strange aspect is that the District Council still has the responsibility of keeping a register of distributors.

No complaints regarding milk have been received in the office during the past year.

The number of samples submitted to the Public Health Laboratory and the results are as follows:—

Samples Submitted Satisfactory Unsatisfactory Bacteriological etal hee 16 . 15 1 Biological es: < 3 — ew ees 1 1 —

Ice Cream

No trouble has arisen with regard to this commodity during the year. There are 19 retailers registered and one manufacturer, 19 visits being paid to the premises concerned and 14 samples submitted for bacteriological examination.

The number of individual manufacturers of jice cream is diminishing, there are now only six different makers represented in the district. This has the effect of cutting down the necessity for a high number of samples as only very rarely do the larger manufacturers’ products fall below Grade 1. Only one unsatisfactory sample was obtained, this being from the local manufacturer, further samples, however, were completely satisfactory.

Food Hygiene

The various food premises, listed below, have given no cause for anxiety, apart from one bakehouse. 46 visits have been recorded and 25% of these visits have been made to this bakehouse. The premises are satisfactory but the manner of working leaves much to be desired. Everything short of prosecution has been tried, conditions are slowly

improving and if this continues the need for extreme measures may be prevented.

A schedule of the food premises in the district is given below:—

Bakehouses ... re Fish Friers ... 3 Butchers 6 Greengrocers 3 Cafes 1 Grocers 9 Occasional Catering .. 9 Ice Cream Manufacturers 1 Public Houses Ice Cream Retailers ... 19 Canteens—Industrial 3 Mixed Foods, etc. 5 Schools ... 2 Food Hawkers ... 10 1 Chemists 2 Cooked Meat and ie manufacturers 5

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Slaughterhouses — Meat Inspection

In August, 1960, the Minister of Agriculture, Fisheries and Food accepted the Council’s report pursuant to Section 3, Slaughterhouses Act, 1958. The appointed day on which all slaughterhouses shall comply with the appropriate regulations was fixed as Ist January, 1962.

Preparations are being made by the slaughterhouse occupiers to put the necessary work in hand. 165 visits were made to the two licensed premises for meat inspection and other purposes.

The work of meat inspection has become almost pleasant now that the shadow of tuberculosis has virtually been removed. The routine inspection for tuberculosis goes on however, the rareness of the condition makes more necessary the need for laboratory confirmation and no doubt, our overworked friends at the Public Health Laboratory will supply the facilities in this area.

The following table shows the details of the slaughtering and inspection at the two slaughterhouses.

Cattle Sheep ex’d’g and Cows I Cows |Calves|Lambs Pigs Number killed 183 19 it die Add T5685 Number Inspected I 183 19 1 014 I 563 All diseases except Tuberculosis TOE LEH PERFOR and Cysticerci

Whole carcases condemned — I — I — um Carcases of which some part I or organ was condemned 26 3 0), — 6 Percentage of number inspect- ed affected with disease other ! than Tuberculosis or Cysticerci) 14.2 I 15.7 ao 1.1 Tuberculosis only Whole carcases condemned — — I — Carcases of which some part I

I I I I Percentage of number inspect- I I

or organ was condemned lie 3 1 I —_ si, ed affected with Tuberculosis I ae ape

Cysticercosis only No carcases were found to be affected with this condition.

The total number of animals slaughtered and inspected was 1,280.

The amount of carcase meat and offal surrendered as unfit for human consumption was 334 lbs.

Food and Drugs Act, 1955 As the Food and Drugs Authority for the area, the West Riding County Council undertake the sampling duties aimed at preventing the adulteration of food.

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This work is carried out by the staff of the Chief Inspector of Weights and Measures, who reports that during the year 12 samples of milk, 2 of drugs and 4 of other foods were taken, all of which were

found to be genuine.

Sse CTI Om

PREVALENCE AND CONTROL OF DISEASES

Details of the monthly incidence and age distribution of cases of notifiable diseases are as follows:—

Scarlet Fever .

Whooping Cough .

I I

Dysentry ... I I No. of cases not- I

9 cases (5 in January, 2 in March and 2 in December).

2 cases in December.

1 case in March.

AGE IN ae

DISEASE I ified and eee ot. cee pe Pee

ee 9—1 I 1—5 I S315 5—25 I 25—45 — 65 +

Vhooping Ge Scarlet Fever _

I

I

I I I I I I I I

Unknown

a i —H

I I Las I I I I I =

There were no admissions to hospitals.

There were no deaths from notifiable infectious diseases.

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Tuberculosis

Two new cases of Tuberculosis (pulmonary) were entered into the Register during the year, as compared with 6 in the previous year.

One death from Tuberculosis (pulmonary) was recorded during the year.

The following table gives details of the number of cases on the Notification Register, together with particulars of new cases of Tuberculosis during the year:—

Pulmonary I Non-Pulmonary

Male I Female I Male ; Female

te a a aa ne ee

(a) Number of cases on Register I at commencement of year ... 1 I 6

(b) Number of cases notified I first time during the year ... Ze) I ae

(c) Number of cases restored to I Register = oF tc TS 1) 1 4 a hs

(d) Number of cases added to Register otherwise than by notification... 7 i Po eae

(e) Number of cases removed 5 from the Register ... od 7 I ae ]

(f) Number of cases remaining’ I I on the Register a 120 7 I 3

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SECTION VII

COUNTY COUNCIL

OF THE WEST RIDING OF YORKSHIRE

DIVISION 20

er

URBAN DISTRICTS OF:—

COLNE VADER KIRKBURTON DENBY DALE MELTHAM HOLMFIRTH SADDLEWORTH

ANNUAL REPORT

OF THE

Divisional Medical Officer

1960 BY

ERIC WARD

DP.

A. T. GREEN & CO. (Printers) LTD. SLAITHWAITE 1961

Page 20

DIVISIONAL STAFF as at 31-12-60

Divisional Medical Officer: E. WARD, «M:R:G:s.; WRG Pep ee.

Senior Assistant County Medical Officers and School Medical Officers:

T. M. B. ROHAN, M.B., B.Ch., B.A.O., D.P.H. (Resigned 30-4-60) W. Pi 8 SLONBHOUSE SM. ROG D. S. PICKUP, M.B., L.M-S.S.A., D.P.H: (Appoimted 1-6-60)

Assistant County Medical Officers and School Medical Officers:

E. By SHAW, ChB. G. M. FOSTER, M.B., CI.B., (Appointed 8-2-60, transferred to division nine, 1-10-60) Clinic Medical Officers (Part time) H. MERCER, jG. WALEER, M8. Ch.B; A. HAND, M.B., ChB. H. C. PICKERING, Te Superintendent Health Visitor: Mrs. A. CORLESS

Health Visitors and School Nurses:

*Mrs. M. W. ALLOTT Miss M. J. MOSS Miss D. BROOKE *Mrs. M. OLDFIELD Miss B. COATES (Resigned 18-7-60) (Appointed 4-7-60) Miss B. I. OWNSWORTHL Mrs. A. M. ELLIS Miss R. PYATT (Appointed 1-2-60) Miss F. B, EMMOTT *Miss L- RIRLEW Mrs. E. FISCHER (Resigned 17-3-60) Miss N, GALBRAITH Mrs. A. ROYSTON Mrs. P. “HARTLEY Mrs. M. C. (Appointed 14-11-60) (Resigned 30-6-60) Mrs. FE. HURLEY Miss M. SANDALLS (Resigned 8-8-60) (Appointed 4-7-60) Miss D. MELLOR *Mrs. M. STAINFORTH (Resigned 30-9-60) Miss M. TRACEY *Mrs. E, MILLAR Mrs. BE: WiILEIAMS (Appointed 4-2-60) Midwives: I Miss A. CHARLESWORTH Mrs.J. COOK (Retired 12-10-60) Nurse /Midwives: Miss A. ASPINALL Miss L. KAYE Miss K. BROOKES Miss E. KNOWLES (Appointed 4-7-60) Mrs. J. LAUDER Mrs. B. BURTOFT Miss M. J. LAKING Miss C. CRABTREE Mrs. E. RICHMOND Miss C. M. DUCKWORTH Wass J. ROTHERY Miss A. T. COBREY (Resigned 30-6-60) (Appointed 12-9-60) Miss M. P. SPRING Miss E. EVANS (Appointed 15-3-60) (Resigned 21-12-60) Miss S. JONES Miss M. SYKES

Mrs. K. M. KAYE Home Nurses:

Mrs. J. HALSTEAD Mrs. H. M. STURGEON Mrs. N. PLATT Miss M. WHITELEY Mental Welfare Officer: Home Teachers for (Mentally) Mrs. M. MOORE Subnormal Children: Miss E. BALL Speech Therapist: Mrs. V. M. E. DUNCOMBE Mrs. M. J. CARTER (Resigned 12-6-60)

Miss G. BURLISON (Appointed 28-9-60)

Senior Clerk: Mr. G. A. BEATSON

* Part time

2a

Page 21

WEST RIDING COUNTY COUNCIL—SERVICES

INTRODUCTION

In this section an account is given of the services provided by the West Riding County Council in the Division.

The Division which consists of the Urban Districts of Colne Valley, Denby Dale, Holmfirth, Kirkburton, Meltham and Saddleworth, has a population of 89,650 and an area of 82,750 acres. Although the population is only slightly more than one person per acre on average, owing to the wild moorland nature of much of the Division the majority of the inhabitants live in small urban communities in the various valleys.

STAFF

The Medical Staff consists of a Divisional Medical Officer who is also Medical Officer of Health for the six County Districts in the Division and two Senior Assistant County Medical Officers (one of whom is also Deputy Medical Officer of Health for all the County Districts apart from Saddleworth, whilst the other is Deputy Medical Officer of Health for Saddleworth only). In addition there are two full-time Assistant County Medical Officers and four part-time Medical Officers who undertake sessional duties at Infant Welfare and Ante-Natal Clinics.

Medical auxiliary staff employed wholly in the Division are one Mental Welfare Officer and two Home Teachers for (Mentally) Sub- normal Children, whilst the Speech Therapist is shared with Division 19.

Details of the Health Visiting, Home Nursing and Midwifery Staffs will be found later in this report.

The statistics given in this section relate to the whole Division but where practicable they are sub-divided into those for the various

districts.

8a

Page 22

I I

I

COMPARATIVE STATISTICS FOR 1960

Denby Dale Ua:

10,165, 9,410

129

a

{3.

as 15-08

Colne Valley UD, ae ee ee eee Area (Acres) . {16,052 Population oi. 21,160) Live Births ..... . 373 Still Births’ "2. =. 8 Deaths: St. 1M == 321 Deaths under 41 year of age... = 5 I Birth Rate Per 1,000 estimated population (Crude) I 17-63 a (Adjusted) I 18-68 “Death Rates All per 1,000 est- I imated population I All Causes (Crude) I 15-17 yy (Adjusted) I 15-47

I Infective and Para- I sitic diseases ex- cluding T.B. but including Syphilis + and othensV .D.

Tuberculosis of I Respiratory system

Other forms of Tuberculosis _ ..... 0-05 Respiratory Diseases (excluding tuber- culosis of respir- atory system) ..... 0-66 Cage ae AS 2-36 Heart and. - atory Diseases ..... 6-85 Vascular Lesions of the Nervous Sys- tem I ore Infant Mortality _..... 13-40

Maternzi Mortality

I I 12.33

{

I

* Figures not available.

AS

Aggregate West Riding 380,334 I 1,187,270 I

19,644

\ t

438 I 14,484 442

16:5

16.7

42.2

12.9

Holm-| Kirk I Mel- ‘Saddle! firth |burton| tham worth I Division > eee No. 20 I I 17,565|14,577| 5,90618,485 82,750 18,730) 18,070 5,290 16,990 89,650 278 I 258 I 78.) 246) 13962 a> (og oc} Get, 351 I 314| 68 I 234] 1404 3 Ss. (vite 28 14.84 I 14-28 I 14-741 15.19 I I 16-03 I 18:42 I 13.33 I 15.92 * I I 18-74 I 17-38 I 12-85| 13°77] 45.66 14.99} 9-91 on 13: 22 * I I Ocal, “Gea I 2 0.06 — I 017] 0.419] 0.42] 0.07 Se eee hee 0-02 1.23} 1:60] 0-95 I 4:47] 1-46 3.04] 249] 4-51 I 1-94) 2.39 8-38 7-91/ 5-10 594] 6.83 3.04] 2-10 I i-5l I 218] 2.36 25-18| 11-63 I 38-46 24:39) 20:56 6 a 0:72 4a,

1-97

22°5

West Riding Admin. County

1,609,759

4,651,960 * 27,935 * 641 * 18,969 628 * 16-9 17: i 17 114-5 44 12°6 lA 0-06 ¥ 0:06 I 0. 0:01 0. 4:17 ’ 4-98 2. 4.35 I 4-85 I 22°65 2} 0:73

Page 23

VITAL STATISTICS

Births

The number of live births registered in the Divisional area during 1960 was 1362 (702 male, 660 female), an increase of 135 compared with the previous year.

The CRUDE BIRTH RATE was 15.19 per 1,000 of the esti- mated population as compared with 13.74 for 1959.

The illegitimate live births numbered 47 or 3.45% of the total live births, an increase of 13 compared with the previous year.

Deaths

The deaths assigned to the Divisional area after correction for transfers were 1,404 (698 male, 706 female), an increase of 68 on the total for 1959.

The CRUDE DEATH RATE from all causes was 15.66 per 1,000 of the estimated population as compared with 14.97 for the previous year.

The following were the principal causes of death in order of frequency :—

(i) Diseases of the Heart and Circulatory System __... 612 (ii) Malignant Neoplasms eb 4 214 (iii) Intra-Cranial Vascular Lesions ... =

(iv) Respiratory Diseases (excluding Pulmonary Tuber- culosis) a ne a ae Ee 2. 104

These four causes accounted for 81.34% of the total deaths.

Infant Mortality

In 1960 the deaths of infants under one year of age numbered 28, an increase of 3 on the previous year. Of these deaths 22 infants were under 4 weeks of age at the time of death.

The INFANT MORTALITY RATE was 20.56 per 1,000 live births, as compared with 20.37 for 1959.

The death rate amongst legitimate infants per 1,000 legitimate live births was 20.53 as compared with 20.96 for 1959.

One illegitimate child died under one year of age giving a death rate amongst illegitimate infants per 1,000 illegitimate live births of }21.28.

The following table gives the causes of death of all infants at various ages under one year:—-

Page 24

Causes of Death he Pneumonia 2. Gastro Enteritis

3. Congenital Malforma- tions oad

4. Premature Birth ... 5. Atelectasis

6. Intracranial haemorr’ ge 7. Toxaemia of Pregnancy 8. Influenza

9. Other diseases peculiar I to eatly infancy

TOTAL

DEATHS OF INFANTS UNDER ONE YEAR OF AGE.

Under I 1-2

em I a I a I i I I I ee

a ° e a

1 day I days

I = = I

Total 9-12 under months I 1 year

Total under 1-3 3-6 6—9 1 month I months I months I months

2 ee

I Total 2-5 I 5-7 under 1-2 2-4 days I days I 1 week I weeks I weeks

3 3

N

=

\ ea

I

cr

Page 25

EPIDEMIOLOGY

Smallpox

No cases of Smallpox were reported during the year.

The number of records of vaccinations and re-vaccinations received during the year was 387 and 13 as compared with 792 and 79 respectively in the previous year.

Details of the various age groups vaccinated and re-vaccinated are given below.

VACCINATIONS RE-VACCINATIONS pobat Pista Gader| = RY I I I f I 18% I 9245") S59) rota Colne Valley ... Ro.) || RU a ee ye —~ I Denby Dale ... 49 I 3 I — I I 83 I I ere Holmfirth .... oo I © I fay & I ve — |e Kirkburton ... ee ae I Oe @ fe Meltham ... ... Mat eb DP Bo ees —, I — I => Saddleworth .., FS I yl Be ee = I i 4 Cradd Lo? 308 |. 50 «a sey S12 I ag

No cases of Generalised Vaccinia or Post-Vaccinal Encephalo- myelitis were reported, and no deaths from any complications of vac- cination occurred during the year.

Diphtheria

No cases of Diphtheria were notified during the year.

Arrangements for immunisation have continued as in previous years, the inoculations being given at Infant Welfare Centres and by private medical practitioners. The response has been reasonably satisfactory as will be seen from the following tables:—

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Page 26

Number of Children Immunised in 1960

Jo

Full Courses”

_Urban District ____ Age at date of Final injection es Uidert 4 i—4 I &—l4 I Total: I Colne Valley ... 220 I 75 11 I 306 Denby Dale _... 91 I 9 zm I 102 Holmfirth a 170 I 73 8 I 251 I Kirkburton sae 145 I 66 15 I 226 I .... 54 I 14 3 I 71 I Saddlewdrth I Total sh 843 I 286 51 I 1180 I Secondary Booster Injection I Age at date of injection ee POT deed I 14 sity Colne Valley ... — I 9 157 I 166 Denby Dale ... I — 13 I 13 Holmfirth ae = I 10 36 I 46 Kirkburton sis oe I 2 100 I 102 Meltham . adi — I 4 29 I 33 Saddleworth _... a= he ) i ee 190, iy Total a — I 47 { 503 I 550

Records of the immunisation state of children in the Divisional area as at 31st December, 1960, are shown below:—

Under I I Total Age at 31-12-60 1 to 4 I 5 to 9} 10 to 14| Under ie., Born in Year| 1960 I 1959-56 (1955-51 1950-46-15 = tiie a ae esi eta Last complete I I I course of injec- I I tions (whether I I I primary or I I I booster) I I I A. 1956-60 153 I 2449 4,469 5,580 I 12,651 I \ I I eal een B. 1955 or earlier) — I I 4220 3134 4354 I I Children under 5 Child en 5-14 —_— Oe _—————_—— Estimated mid- I year child population 5,500 13,800 19,30€

Percentage of child population last immunised 1956-60 (whether pri- 47.31 mary or booster)

65.55

Whooping Cough

The restricted scheme for the immunisation of children against Whooping Cough has continued throughout the year. Supplies of vaccine can be obtained by medical practitioners on application to the

Divisional Medical Officer and children up to the age of 4 years may be immunised.

The inoculations have been carried out by private medical practi- titioners and at Infant Welfare Centres and during the year 1,100 children received protective treatment as follows as compared with 912 in 1959:—

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Page 27

District Age at date of final injection

under6/12/6/12—1 I 1—2 I 23 I 34 I I Colne Valley 87 129 I 37 I 12 I 3 268 I Denby Dale 31 Cis eet I 1 1 oo" I Holmfirth 64 103 I 57 I 8 4 I 236 Kirkburton 73 94 I 40 I 9 4 I 220 Meltham oa my i 1 70 Saddieworth I 87 i oo: I G I a” I I Total 2 eee ADS ili BS ft 409 fey AS noi Dysentery

During the year 69 cases of Sonne Dysentery occured in the Division as compared with 43 cases in 1959.

The cases occurred as follows: —

Quarter Colne Denby Holmfirth Kirkburton Meltham Saddlew'th Total Valley Dale ih Nes A nihil 2nd 1 — — 15 1 20 37 3rd —- —— — 3 — — 3 4th a: — = — — — ae Total 11 os -- 21 1 36 69

The age distribution in the various districts is shown below:—

Age Colne Denby Holmfirth Kirkburton Meltham Saddlew th ‘Total Valley Dale Pre-School 6. fc TR Me maa as AO ee School 1 pit, ae 10 1 a a Adult 4 ins 6 7. a Total 11 ig fly 21 1 a6 da

Food Poisoning

One outbreak of food poisoning came to notice during the year. This was in Colne Valley and involved 11 persons. The food thought to be responsible was gravy made from mutton stock and served at a mid-day meal in a small cafe where the food storage facilities were unsatisfactory.

Heat resistant clostridium welchii was recovered from the faeces of 11 cases, from three food handlers in the cafe and from cold mutton fat.

Page 28

Mass Radiography Service

Details of ths Surveys carried out in the Divisional area during the year are as follows:—

Abnormalities Discovered

Survey undertaken at Number Tuberculosis el Ex’min'd Active I Inactive ies (1) (2) (3) (4) (5) (6) The Mechanics’ Institute, Uppernull. Saddleworth U.D. 1530 2 13 q 22

Ltd.; Greenfield Paper Mill. I Saddleworth U.D. 369 = =, 3 3

The Drill Hall, Springhead. Saddleworth U.D. 481 1 3 3 7 The Drill Hall, Thongsbridge. Holmfirth U.D. 1493 3 7 6 16 I TOTALS 3873 6 23 19 48

Acute Poliomyelitis

No cases of Acute Poliomyelitis were notified during the year.

The arrangements for vaccination against poliomyelitis have cont- inued and in February the scheme was extended to persons who at the time of application had not reached the age of 40 years.

During the year 2,674 persons received two injections and 5,500 received their third booster injection. Thus, at the end of the year, out of approximately 45,000 eligible for treatment 21,294 (46.88%) had received two injections since the commencement of the scheme and of these 18,422 (40.94%) had received their third injection.

MIDWIFERY AND MATERNITY SERVICES

Domiciliary Midwifery

The number of cases attended by the domiciliary midwives during the year was 371 as compared with 344 in 1959.

At the commencement of the year, 2 whole-time midwifes, and 13 nurse/midwifes were engaged in the Division. During the year one whole- time midwife retired and two nurse/midwifes resigned their appointments whilst three nurse/midwifes were appointed and one home nurse was I redesignated

10a

Page 29

At the end of the year the staff consisted of one whole-time midwite and 15 nurse/midwives.

Three independent midwives signified their intention to practice in the area. Two of them came into the area each to attend one case only.

Of the cases attended 2 were twin births, 3 were patients who normally resided outside the Division (outward transfers), one case was attended on behalf of a neighbouring Division, and one was a patient in a local mental hospital who was attended at the request of the Medical Superintendent.

Thus 368 of the births attended were attributed to the Division. Of the remaining 8 births attributed to the Division, one was attended by a midwife from a neighbouring division, and 7 were inward transfers.

In addition 8 miscarriages were also attended by domiciliary midwives.

The services of the domiciliary midwives continued to be offered to all patients confined in hospitals or maternity homes but discharged home before the 14th day of puerperium. In September this was reduced to the 10th day. During the year 255 such patients received nursing care, 1059 individual visits being paid to them.

Of the 1,391 births notified and attributed to the Division 376 occurred at home. The 20 Home Nurse/Midwives together attended 302 cases as Midwives and 32 as Maternity Nurses. They paid 3,717 ante-natal and 7271 post-natal visits. Two Home Nurse/Midwives attended 36 cases each. Four attended over 25 cases each and 8 attended 10 cases and over. Only 12 of the Nurse/Midwives were employed throughout the year. The independent Midwife resident in the area attended 33 cases as a Midwife and Z as a Maternity Nurse. Two cases were attended by private Midwives who notified their intention to practice in the area. I

Notifications:—

The following notifications were received from midwives prac- tising in the Division:—

Death cf Child ...

be

Stillbirths ae aor re i bi oe 7 Artificia] Feeding as ab oe oe 54 Liability to be a source of infection ... ame cae 4

Ila

Page 30

Medical Assistance:—

Medical aid forms sent in by midwifes during 1960 numbered 186 (90 domiciliary, 96 institutional). The following table summarises the

cases for which medical aid was sought:—

PREGNANCY LYING-IN Dom. Inst. Dom. Inst. Abdominal pain 1 — Breast condition . Abortion threatened 2 — Fit 5 hrs. after delivery 1 — Ante-partum haemorr’ge 2 — General condition » ee Maconium stained liquor 1 — Post-partum haemorr’ge — Z Past obsteine history 1 — Puerperal Sepsis ... 1 — Post-maturity in ee, ee Pyrexiq 1 — Toxaemias—albuminuria Varicose Veins 1 — oedema 1 — 100 — 7 2 LABOUR THE CHILD Dom. Inst. Dom. Inst Cesarean Section oo 3 Asphyxia 1 — Contractions 1 in 5 mins. Chest condition 1 (Foetus dead) 1 — Congenital Defect 1 — Episiotomy 1 9 Death 1 General condition shirt — Eye condition 3 Intra-partum haemorr’ge — General condition .. 5 a= Labour = delayed 6 16 Pneumonia 1 — premature 1 — Rhesus negative 1 — Laceration — labial 1 2 Stillbirth . 2 1 —perineal 35 52 ee —vaginal — 1 16 1 Malpresentation 2. 3 6 Multiple delivery 1 1 Prolapse anterior lip cervix 1 — Retained placenta ... 5 2 Rigid perineum — 1 Ruptured Membranes 1 — Uterine Inertia 1 1

57 93

Gas and Air Analgesia

At the end of 1960, all the 16 midwifes in domiciliary practice held the certificate in Gas and Air Analgesia administration and were equipped with the necessary apparatus.

Analgesics were administrated by domiciliary midwifes to 227 cases, or 61.19% of the cases attended, as compared with 211 cases in 1959.

Pethidine was administered by domiciliary midwives to 190 cases or 51.21% of the cases attended, as compared with 209 cases in 1959.

12a

Page 31

As from the Ist April, 1960, approval was given to the provision of apparatus for the administration of trichloroethylene for use by domiciliary midwives with the necessary training. At the end of the year, 5 midwives had been supplied with the apparatus and trilene had been administered to 25 cases or 6.74% of the cases attended.

Ante-Natal Clinics

During the year 99 patients made 247 attendances at the various clinics, details of which are given in the following table:—

No. of No. of No. of Average at- Clinic sessions patients attendances I tendance per session Rikers © 6 is bd I Springhead 12 43 121 10.08 Uppermill .... Ba iw 39 60 5.00 I *Denby Dale ... i 12 1 2 0.417 I *Lepton Ee. my 12 15 64 5.08 I *Skelmanthorpe a 12 1 3 0.25 Total ... 60 99 247 4.42

=

*Combined with Infant Welfare Clinics

Apart from the separate ante-natal clinics held monthly at Uppermill and Springhead and the combined sessions at Lepton, very little medical ante-natal care is given at any of the Local Authority’s clinics.

During the year only 99 patients consulted the clinic Medical Officers and all but two of these attended either at Uppermill, Springhead or Lepton. In all, there were 247 medical consultations and all but five of these were at the three clinics named above.

The falling off in attendances is due partly to the fact that a general practitioner/obstetrician is booked to give full obstetrical care in 96% of the cases attended by the domiciliary midwives and partly to the practice of the hospital staff of referring hospital booked patients to their family doctors for intermediate ante-natal care between hospital visits rather than to Local Authority’s clinics.

With regard to the sessions combined with Infant Welfare one session per month is designated as that at which ante-natal patients can be seen but in actual fact as many patients attend on other Infant Welfare session days.

The arrangements made in 1959 with a general practitioner/ obstetrician in Meltham for the district home nurse/midwife to attend the weekly ante-natal clinics conducted by the doctor in his surgery have continued. In March, 1960, similar arrangements were made with a general practitioner/obstetrician in Golcar. Particuars of attendances at these clinics are as follows:—

No. of No. of attendances Sessions Ante-natal Post-natal Golcar 31 160 18 Meltham 36 138 21)

18a

Page 32

There were, however, fairly good attendances at the ante-natal Relaxation classes run by the midwives and health visitors, the total attendance of 1,118 being 52 more than in 1959.

I Average Clinic No. of No. of I No. of attendance Sessions Patients j|attendances I per session Denby Dale... 46 26 I 157 3.41 Kirkburton,...: ae 49 29 202 4.10 Lepton i 5s 50 38 I 238 I 4.76 Meltham ne ae 47 Le pee 2.70 Slaithwaite _... Me, 48 69 I 330 6.87 *Uppermill aR a I 10 11 I 59 5.90 Dotavie.... 250 200 oid 13 4.45

*Classes re-commenced October, 1960.

The relaxation class for Holmfirth mothers is still held at the Holme Valley Memorial Hospital and is attended jointy by patients booked for confinement at the hospital and at home. During the year, 59 patients made 234 attendances. The arrangement i; not wholly satisfactory as there seems to be little opportunity to teach mothercraft at the classes.

Flying Squad Arrangements

The arrangements for “‘Flying Squads’’ based on the Hudders- field Royal Infirmary and the Oldham and District General Hospital have continued but no calls were made on either squad to attend patients in the Division during the year.

Institutional Midwifery

More difficulty is now being experienced by expectant mothers regarding the booking of hospital maternity accommodation. |Home circumstance reports are supplied to the hospital authorities on request and from these, social priority for admission is decided. Of the 1,391 births attributed to the Division, only 376 or 27.03°% took place at home as compared with 342 or 27.45% in the previous year. A summary of the cases for which medical aid was sought by midwives in institutions is given on page 12a.

Premature Babies

During the year 83 babies weighing 54lb. or less were born in hospitals or nursing homes to mothers normally resident in the Division and 22 were born at home. Of those born at home one survived only one day, but the remainder were surviving at the end of the month.

At the end of the year there was one midwife who had special

training in the care of premature babies, having attended a course at the Sorrento Hospital, Birmingham.

Two premature baby outfits are available in the Division but these were not called into use during the year.

14a,

Page 33

ADMISSIONS TO MATERNITY HOSPITALS

Leg q a ge ee eae 3 ey > a 2 © v I a rv q = te Place of Confinement 3 a Ge Hy a oO 5 I Ce ee ee eee oe or ee I I I Princess Royal Maternity Home ... biz I 58°" ls PP PG I 30 I 1 I 329 I Woodfield Maternity Home ... tbs I I 41 I 41 I I Holme Valley Memorial Hospital, .. ele ot ow I ae I de I 217 I St. Luke’s Hospital, Huddersfield 129 I 5 I 11 I 44 I 39 I aie I 291 I Huddersfield Royal Infirmary 26 9 I 123 I 3 I ce I 73 I I I Oldham & Dist. General Hospital —| —|—|-— I — I 106 I 106 I General Hospital, Ashton-u-Lyne... at a fe, ae I oe I ha 6 I I Other Maternity Hospitals ... .... 1 2 I 2 as oe 5 I I Other General Hospitals oe me 2 5 — 2 4 13 Private Nursing Homes 1 +34 T I 1 a query Total Institutional ... 27 I 78) 253 18s. 65 I 159 [1015 I I Domiciliary 105, |.a3 43 69 8°) 376 eet et: I I I I I Total Confinements ... 376..| 1324) 2296.) 257 73 |..257,.11394 I I I I I bs THE FATE OF PREMATURE BABIES BORN IN THE DIVISIONAL AREA pena St Le EL ne ee Number of Premature Births Number Dying Number Surviving| Percen- I Percent- Weight «|——___———_—__| Gays of survival). Over 28 Days tage age Group Born Alive Survival I Survival lbs. 9 Born —_—-__-_—-_| in 1960 I in 1959 Be Ce ead I ai A. — BB Gee bea: dey ad I Om ORE OTe GCI Reich So dete eras im Ary |S ges te I SES) opel Ey of Be toe 81:25 eke 4 cers athe, I Ae a Li Borg Wo henge 75:00 33-4 E. (ROS “BONER VETS te ee eee oF ax 100.00 3-34 Bocce [eg ph Eel 4 BS) Ne Sec eee 24-3 toes 1 at) lm tT ont tee ee ee — 2-24 AS TORS Teg Badal 2 HS eee 14-2 TIL yong 2 PS pee ee ee 00 00 I 1-1} Se Gr 4 I BPE OR a, Ot OO) 00:00 22 24 59105| 18 I 7 2 2 2 21 22 49 92| 8762 I 85:93 _

tal adjusted live births

Ais

Born at home and attended by a midwife.

mber of live premature births 105 B2; Born in a Maternity Home. rcentage of total live births _....... we 7°58 C: Born in a General Hospital. mber born dead ae ja sd: le TT: Total

Page 34

CHILD WELFARE

Distribution of Welfare Foods

There has been no change in the arrangements for the distribution of Welfare Foods, except that the Shepley centre was closed in February

because of the fall in demand.

At the 20 distribution centres in this Division the welfare foods distributed during the year, and the comparative figures for 1958 and

1959 are as follows:—

National Dried Milk (tins) ...

Orange Juice (bottles) ...

Cod Liver Oil (bottles)

Vitamin A & D Tablets (packets)

1960

Deals 36,012 6,390

4,022

Infant Welfare Clinics

1959

6,844 38,296 6,651

3,915

1958

——

8,888

31,930

6,335

3,518

There has been no change in the arrangements at the Infant Welfare Clinics in the Division.

During the year 2812 children were seen and a total of 24,669 attendances were made, details of which are shown in the following table, as compared with 2,615 children and a total of 26,316 visits in

the previous year.

I ; No. of attendances I l No. of children who I by children who at. Average at- I No. attended and who I date of attendance I tendance per orn were I Session Clinic |sess-| 1960|1959|1955|/Total I |1—2/2—5] I i Yh 2.9) se I ions| I I -5 yrs.| yrs.| yrs. «| YS: ah I 50 I 39] 79] G5 I 183 I 635| 196| 197] 1028 {9. aoe 3.92) 3.92 MRO eres. I 52 I 87 I 52) 54 I 193 I 1470] 280] 129] 1879, 38.36] 5.38! 2.48 Greenfield ....... I 52 I 531] 93| 51 I 197) 691] 297] 337] 1325 13.981 5.711 6.48 Holmfirth 1. B1 78| 56 I 215 I 1174] 369] 260] 1803) 99.57) 7.00] 5.00 ti, yen! - Wiok -82| 45.) 182 +985) 49.97) 5.27), 3.50 Kirkburton ...... |. 50.\\p 52 I 1i1| 54 |. 217 I 1476|,293| 163| 2359). 5.86], 3:26 Kirkheaton ..... I 48 I 74 24| 11 I 147 I 1016] 274| 176| 1466) 21.16] 3.67 “Lepion wings: I 51 14) 9 I 116 I 1053|_ 190| 427| 4370)» 20%4| 3.72| 2:49 Linthwaite ...... I 48 I 50 I 58] 33 I 141 I 957] 338] 83] 1378] 19.93] 7.04] 1.72 I Magsdem I 52 |. 58.| 47] 26 I 131 I 352| 373) 1726) 19:25/ 6.76] 7.17 Meltham — I 50 I 46 I 61] 33 I 140 947| 272| 99) 1318) 18.94] 5.44] 1.98 I New Mill ......... I 51 I 41 I 44) 77 I 164 I 824] 245] 313] 1382) 16.15] 4.80] 6.13 Slaithwaite a on I 69 I I 228°) 129%; 423] 299| 2013) 25:31] 8.29} 5.86 Springhead ...... I 51 I 71 I 89} 46 I 206 I 1381] 550) 446] 2377| 27.07 10.78] 8.74 Denby Dale ....| 24 I 46 I 40| 18 I 104 I 127| 44| 716) 22.70] 5.29] 1.83 Skelmanthorpe .| 24 I 25 I 31| 7 I 631 521] 100] 24] 645} 21.70] 4.16] 1.00 Uppermill .......| I 51 I 83] 51 I 185 I 825| 218] 135] 1178] 15.86| 4.19] 2.59 I [809 I 983 |1051|733 |2812 20.39] 5.92] 4.18

The monthly sessions of the Weighing Centre at Emley have con- tinued, 17 individual children having made 108 attendances, as compared with 8 children making 90 attendances in 1959.

16a

Page 35

Nurseries and Child Minders’ Regulations Act, 1948

One person in the Division is registered as a child minder. She . . . ae . . . was registered in March 1960, to mind 5 children (including her own 2)

but it was not until December 1960 that she commenced to take in children. At the end of the year, in addition to her own two children, she was minding two children on two days a week from 11 a.m. to 4 p.m.

There are no day nurseries in the area provided by the County Council.

SCHOOL HEALTH SERVICE

Introduction

This account of the School Health Service is a Divisional report and is a combination of the reports already presented to the Upper Agbrigg Divisional Executive and the Saddleworth District Sub-Com- mittee. The statistics relate to the whole Division.

Schools in the Area

There are in the Division 78 schools or separate departments, which include the Royd Edge Special School, Meltham.

The approximate number of pupils on the registers in December, 1960, was 12,297 (a decrease of 47 as compared with the previous

year) and was composed of:—

Infants Juniors Seniors 2,762 4,442 5,093

Of the 71 Primary and ‘‘Through”’ Schools 35 are Voluntary and 36 are County Schools.

The distribution is as follows:—

Lie ee ae eee Colne I Denby I Holm- ral Mel- I Saddle-| Total Valley Dale I firth ; burton) tham [| worth Type of School oO oO ort O° os oO res oO r= oO =} oO atela/&alalatal @)s|/ ala) 2] 2) a 3 3 3 S Al I HA} & I a a I a) mu 13] & I Primary. ... 9| 14/1420!13]/1243[ 5] 527] 12/1223] 70| 7060 Secondary Modern ... I -| —| 1| 712] 1| 871] 1| —| —| 1] 458] 4] 2439 ee ee ia eee Tad ea ih Grammar eee f=] 6] —| 809/-| —| —| —| —| —|] 1] 809 Comprehensive 111746, —| —| —| —\-| —|/—| —| 1| 1746 Special pal pa. I =.) (‘| eee il I oe All Types... {18/3592| 10/1513} 16]3100/15|1830| 6] 581| 13/1681] 78]12297

Pupils from Saddleworth attend Hulme, Oldham and Manchester Grammar Schools, but so far as the Schoo] Health Service is concerned they are the responsibility of the Oldham County Borough Council, and of the Medical Officers of the Independent Schools.

Some pupils from outlying parts of the Division attend Grammar Schools at Mirfield, Penistone, etc.

17a

Page 36

Medical Inspections The periodic medical examinations have continued as detailed in

previous reports. In all 147 separate inspections were carried out at the 78 schools in the Division.

Periodic Medical Inspections

During the year 5,551 periodic inspections were carried out as compared with 4,765 in 1959.

The number of children inspected in the various age groups is as shown in the table on page 20a. Findings of Medical Inspections

The following figures show the incidence of certain defects in the 5,551 children who were examined at the periodic inspections:—

No. of Children Requiring

Defect or Disease Treatment Observation Nose or throat ee ae 86 342 SPCC i oe 32 51 Lymphatic Glands 1 112 Heart and Circulation ‘oe on 71 Limes ee Ret ee a. 54 182 spor ee ot 245 238 ips) OB) Greens a ate 363 1032

Further details will be found in the table on page 19a.

Particulars of the age grouping of children found at periodic medical inspections to require treatment are given below:—

a

For Defective I For any of the Vision other conditions Total Groups (excluding recorded in Individual Squint). table of defects Pupils

a er

Entrants 1 Bi Ba 42 184 205 7 to 8 year group 73 127 195 Last year primary mat dee 145 216 319 Last year secondary .... ie 73 166 234 Ia 303 693 963

OL a

18a.

Page 37

Defects Found at Medical Inspections

The following table gives details of all defects noted at both

periodic and special examinations. All defects noted at medical inspec-

tions as requiring treatment are included, whether or not this treatment

was begun before the date of inspection.

Defect or Disease.

1

Requiing Treatment

I 3803

43 17

Skin Eyes: (a) Vision (b) Squint (ey Ears: (a) Hearing ie aes (b) Otitis Media ee (ey ce

Nose or Throat ....

Speech

Lymphatic Glands

—e

Heart and Circulation

Lungs Developmental (a) Hernia (b) Other

Orthopaedic (a) Posture (b) Feet LG) Nervous System (a) Epilepsy .... (b) Other

Psychological (a) Development I (b)

SSS ee

Abdomen

TOTAL

13

Number of Defects.

Petiodic Inspections

163

996

Special Inspections

os

Requiring Requiring Observa- I Requiring I Observa- tion butnot| Treatment tion but no freatment I treatmentt 67 7 I 29 965 167 664 54 23 a2 1) 2 48 {1 13 40 _ 14 20 Z 10 342 112 I 225 51 43 I pie 112 3 I 29 71 7 I 51 182 12 97 3 5 1 481 7 AO 29 6 22 104 68 65 105 36 63 13 4 4 34 2 40 1415 90 24 a 98 3 13 18 = I 5 12 i ag 2677 617 I 1452

Physical Condition of Children

All pupils at routine medical inspections are classified as to their

physical condition at the time of the inspection.

and ‘‘Unsatisfa

ctory.’’

19a,

The classifications are

I

Page 38

Details of the children inspected during the year, together with comparative percentages for 1959, are as follows:—

a

eat

I

|Number of I Satisfactory Age Group Pupils I I % of I % in I % of I % in| ee a Inspected I No. I Col.2 I 1959 I No. I Col.2 I 1959 I I I I Entrants ei eke 928 gi5 I [| 0:9 7 to 8 year group... 1231 (2991 990°) SOB" 42 1 2.0). Last year primary 1723 L706.) 99:0 I S855 97 I a0 ees Last year secondary 1669 1GOA, I - 9977 208.7 5 1 OS hes ws ae ia I fie, ae ee I I I I I I TOTALS 5551 5504 I 99.2 I 99.5| 47 I 0.8 I 0.4 I I I I

Other Examinations

In addition to routine, special and follow-up examinations ot children at school medical inspections, children were examined at home or at school for various reasons. These include non-attendance at school, children returning to special schools, and also those examined with a view to providing special educational treatment.

Uncleanliness

The total number of inspections made during the year was 29,199 and 377 instances of infestation were found as compared with 27,902 and 248 respectively in 1959. There were 259 individual children (2.11% of the school population) found to be infested on at least one occasion, an increase of 89 as compared with the previous year.

Statistics relating to these inspections are as follows:—

Total number of warning letters sent se $4! 135 Total number of exclusion notices served ... ...... nt ot 14 Total number of home visits paid ... ine hi Fs ek 166 Total number of individual children found to be verminous ... 259 Total number of Cleansing Notices issued a 2. 11 Total number of Cleansing Orders issued ... ot ee 8

Arrangements for Treatment School Clinics

There are no special School Clinics set up in this Division but minor ailments receive attention and ‘“‘booster’’ doses of diphtheria prophylactic are given at 17 Infant Welfare Clinics in the area. During

the year a total of 584 attendances were made by school children at such clinics.

Special Clinics Ophthalmic Clinics

arrangements detailed in my report for the year 1950 have continued, Dr. J: V. Kirkwood devoting two sessions per week to clinics in this Division. Additional sessions are arranged when necessary.

20a

Page 39

During the year 72 special clinic sessions were arranged and these were attended by 946 children who made 1,124 attendances. Spectacles were prescribed for 354 children, 363 were found not to require any change and 229 did not require spectacles.

Cases requiring orthoptic treatment may obtain this either through the hospital servicd or, if in the Saddleworth area, they may attend the Orthoptic Clinic, Scottfield, Oldham, which is provided by the Oldham Education Committee. A charge of 5/- per attendance is paid by the West Riding Education Committee.

Ear, Nose and Throat Clinics

Arrangements whereby the staff of the Ear, Nose and Throat Department at the Huddersfield Royal infirmary provide special sessions for West Riding children continue, but owing to the increase in referals by family doctors to the Hospital Out- Patient Department it was only necessary to hold one special session during the year at which 16 children were seen, 8 being referred for operative treatment.

Orthopedic Clinics

The special fortnightly sessions for West Riding children have continued at the Huddersfield Royal Infirmary. These have been con- ducted by Mr. J. Hunter Annan, F.R.C.5., Consultant Orthopedic Surgeon and by Mr. G. F. Hird, F.R.C.5 , Assistant Orthopaedic Surgeon assisted by Miss M. J. Moss and a clerk from the Divisional Health Office.

School children and pre-school infants with orthopedic defects are better seen at these clinics than at Out-Patient sessions at the hospital, and the clinics have been very well attended.

At the 21 sessions held during the year 294 individual children made a total of 390 attendances.

No children from the Saddleworth area were referred to the Gainsborough Avenue Clinic, Oldham.

The conditions for which they were referred were as follows:—

Tee dog ce 40 CPE CHIE acs. > ene ne es 9 Knock 2988: 38 Hallux. Valgus <0 sue. 37 Other Deformities of 37 cn. je, Postural en 17 Other Deformities ...... 28 Congenital Conditions... 16 Acute Poliomyelitis 10 Perthes Disease Pie Se 9 Tubercular Conditions ... 1 Other Conditions —....2! ou: 40 Total 294

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Page 40

Child Guidance Treatment

Dr. S. M. Leese, the County Psychiatrist, along with Mr. Pickles, the Clinical Psychologist, continued to hold clines at Mirfield and during the year 17 individual children received treatment.

Ultra-Violet Ray Treatment

Facilities are available for treatment by Ultra-Violet Radiation at Golcar, Holmfirth, Denby Dale and Uppermill. Cases for treatment are referred by School and Infant Welfare Medical Officers and by General Practitioners, but very few were referred during the year.

Speech Therapy

Sessions for Speech Therapy have continued throughout the year, these being held at the Divisional Health Office, Golcar; Mechanics’ Institute, Uppermill; County Clinic, Slaithwaite; Council Offices, Honley; County Clinic, Kirkburton; Royd Edge Special School; and Colne Valley High School.

The weekly session at Colne Valley High School, started as an experiment last year, has been held throughout this year with promising results, so this should now continue. The waiting list has unfortunately grown longer again for parts of the area but I am pleased to report vastly improved regularity of attendance at all centres.

It is expected that in 1961 we should have a Speech Therapist full time in the Division and to be able to cover the area satisfactorily for the first time.

During the year 255 sessions were held at the various centres. The total number of attendances made by the 127 children was 1453.

Details of the children treated are shown in the following table:—

No. of new cases treated during year. ... a a2 es 44 No. of cases already attending for treatment from previous year 83 Total number of cases treated ... Bi sas ie ee No. of cases discharged during the year:— Speech Normal ... om ott a ee ate 27 Speech Improved co re on ce ty 13 Unsuitable for Treatment 2% =n exh de 1 Left School sas ee sip Bt he ts 4 By reason of non-co-operation oo Bu ex 3 lente —"... ie a ne :. ue Geog 2 No. of cases awaiting treatment at the end of the year ... 22 No. of visits made to schools ... te ht tah st 5 No. of home visits... al Bt me mn ais ae 5

22a

Page 41

Treatment Tables

The following tables give details of treatment given to school- children under the Authority’s schemes and otherwise. The treatment provided otherwise than by the Authority includes all treatment known by the Authority to have been so provided, including treatment under- taken in school clinics by the Regional Hospital Board.

1. Diseases of the Skin

ee ——___.

———$=—— eS hina en

Number of cases treated or under treatment during the year by the

I Authority I Ringworm: (i) Scalp... sa ie =~ 4 me rT (i). Body an ao i I Scabies a i =f an ee Impetigo — Other Skin Diseases I a Total. "a —

2. Eye Diseases, Defective Vision, and Squint.

Number of cases dealt with.

By the Authority Otherwise External and Other, excluding Errors of a aes I Refraction and Squint ... i see ook 18 I Errors of Refraction, including ae 1234 I A gk Be Mika pe nes — 1252 I Number of Pupils for whom Spectacles ———

were prescribed ... an oh a — 610

——<

3. Diseases and Defects of Ear, Nose, and Throat.

eee

Number of cases treated.

I — ________—

By the 3y the Authority Otherwise Received Operative Treatment:— I (a) For diseases of the Ear ... ' se (b) For Adenoids and chronic Tou sillitis I (c) For other Nose aid con- ditions I Received other its of I see \

...

a

Total number of pupils in schools who are known to have been provided with hearing aids:—

(a) in 1958 ... a al e ary I 54

(b) in previous years... ey — I 7

Page 42

4. Orthopedic and Postural Defects

By the Authority Otherwise Number of pupils known to have been rE aR treated in Clinics or Out-Patient ments _- 31

Number of pupils treated at school for postural defects

5. Child Guidance Treatment

Number of pupils treated at Child Guidance Clinics under arrangements made by the Authority . wits 17

6. Speech Therapy

Number of pupils treated by ae under arrangements made by the Authority . 127

7. Other Treatment Given

(a) Number of cases of miscellaneous minor ailments treated

by the Authority _... 236 (b) Pupils who received convalescent treatment under School Health Service arrangements alt st ihe 1 (c) Pupils who received B.C.G. vaccination ... 2 IOSD (d) Pupils who received Ultra-Violet Light Treatment _... 3

8. Tonsillectomy

Out of the 5,551 pupils examined at routine medical inspections

275 were found to have undergone tonsillectomy during 1960 or previously.

Dental Treament

A full dental service is now available throughout the Division.

Details of the work carried out during the year are summarised

below:— Total number inspected ... Total number found to require treatment — an 6,812 Total number treated ae sen or mete 3,868 Total number of attendances fee ay 7,479

Hospital Schools

Children requiring prolonged hospital treatment are now often admitted to special “‘long-stay’’ hospitals, many of which have educa-

tional facilities which are recognised by the Ministry of Education. They are known as Hospital Schools.

24a

Page 43

As the arrangements for admission are made by the Hospital Authorities it is not possible to give details of the children receiving treatment.

Convalescent Home Treatment

Arrangements are made for selected school children to be sent to Convalescent Homes at the expense of the Education Committee. The children selected are usually suffering from general debility and the need for convalescent treatment is approved by the School Medical Officer before financial responsibility is accepted.

During the year one child was sent to a convalescent home at the expense of the Education Committee.

Infectious Diseases

The table on page 26a shows the number of confirmed cases of infectious diseases occurring in school children.

There was an increase in the incidence of Scarlet Fever and Dysentery during the year when 75 cases of Scarlet Fever occurred as compared with 54 cases in 1959, and 31 cases of Dysentery occurred as compared with 21 in 1959.

In addition the following cases of other infectious diseases were reported by various Head Teachers.

Scabies eat sit a Z , ss 57 Impetigo... oe By. 1 Influenza ... ait ak Z Chicken Pox ae 60

Page 44

SCHOOL

Scarlet

Oo Hm mB 09 DD 69!

no] I ee eat I lel eS a ‘Tuberculosis

I Whooping I Cough ‘Tuberculosis Pulmonary

Naw Pu:

I Fever

GOGAT caer cc Lanthwalte Of Wooo tee Lanthiwaite (County 200. 2. OS Linthwaite County Infants ...... I Marsden, Marsden County Infants _......... I Niclds.. oe I Scammonden C I Slaithwaite: C: of MB; I Colne Valley’ Highy I ons I HoimbridgesC... Of I Hobnirth junior “County ......3.. RO: A. Upperthone Gt... Paes. nee WV GONG ONG ces fhe. sees Hew Peas cee Fiocktomw ©. Of Kirkburton C. Of EB. ace eee: ee Kirkheaton Lepton, Wis ie I Snelley "©, "Ol HHA Ir ida. nee. eco — EA... aie. — Clayton “West Cotiaty — Denby —- Denby Dale (County. cn os ae ANEMONES Mess ten 2 EO OE UG, — I Skelmanthorpe ©. Of FE. — I Meltham (C..-Gi Fe. al Die — I operess Or Ey — I iso ssc noice ba — I Delp ve aed 52)... a I County 6.0.06 00. — I C. Gi Te sues — I I I I I I I

[oe Be or ty

pet, x)

— f

lL 1 I Se I N= I

I

tht 111 Wl b Blela & Ba)

PL Te BY lel [1 ieee I I oe tel DE 1G] ee edt

pot bo

My ee Me OL iiss eine se — Sadaieworth Parochial ..........+. — CAG COUNTY — Springhead County Infants ........ Uppermill Secondary Modern ...... —

tes. a, I I I Melee fy Rg Me GEN gs [Banas

ool eel lel I I

qu on fap) o> bs

Diphtheria Immunisation

The previous arrangements for diphtheria immunisation have continued, the injections being given by private practitioners, at the Welfare Centres, and at several schools.

The majority of children are now immunised before entering school. This should always be the case and the importance of immunisation in infancy cannot be over emphasised. Children protected in infancy should have booster injections when they commence school and five years later.

26a

Page 45

The following figures indicate the number of children who receive primary immunisation after entering school and also the number receiving re-inforcement

Primary Re-Inforcement Immunisations Injections Colne Valley 5 Re $3 11 166 Denby Dale I sa gre 2 13 Holmfirth a) ee ah 8 AG a ae mae 15 102 Meltham La 3 33 Saddleworth = hs jy 190 51 550

—_——

These figures are much below those of two or three years ago, the fall being mainly due to the fact that immunisations done in schools were reduced owing to the time taken up with poliomyelitis vaccinations.

B.C.G. Vaccination

In accordance with the County Council’s scheme for the pre- vention of Tuberculosis, arrangements were made to offer B.C.G. Vaccination to all children aged 13 years and over. Vaccinations were carried out during March and September, when 659 children were vaccinated.

Details are given below of the work undertaken during the year:

Number of children offered B.C.G. 1g Py 1789 Number of acceptances oe oe in 929 Number completing skin testing (including children brought forward from previous year) 918 Number positive... xa a a Fi 207 % Positive... Ex Aa ee Rs wing Number negative... oe ne a = 670 Number Vaccinated ... i en ae 659 Number of Skin Tests after 12 months ... ey 178

Protection of Children against Tuberculosis

The arrangements for the X-ray examination of the chests of all new entrants to the teaching profession and non-teaching staff of schools have continued.

Whenever the Mass Radiography Unit is available in the area the facilities are offered to all classes of staff dealing with children. The response from the Nursing and Teaching staffs generally, has been satisfactory, but the response from non-teaching staff at some schools leaves much to be desired.

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Page 46

The children found to be mantoux positive as a result of tests for B.C.G. vaccinations are invited to attend for X-ray examination when the Mass Radiography Unit is operating in the area.

Deaths in School Children

During the year 7 deaths were registered amongst school children (3 boys and 4 girls). The following are brief details:—

Sex and Age Area Cause of Death

1. Female (age 9) Holmfirth la. Broncopneumonia. 11. Primary amentia and epilepsy.

2. Male (age 7) Colne Valley Haemorrhage due to traumatic laceration of liver, spleen, and lung, caused when knocked down by a motor vehicle in Manchester Road, Marsden.

3. Male (age 7) Colne Valley Shock and haemorrhage due to multiple injuries as a result: of being knocked down and run over by a motor vehicle.

4. Female (age 11) Holmfirth Acute cardiac arrest due to reflex inhibition due to emotional shock caused when she saw her sister lying injured in the road outside

her home. 5. Female (age 9) Meltham Meningitis. 6. Female (age 7) Meltham Congenital Heart Disease.

7. Male (age 14) Saddleworth Haemorrhage and shock due to laceration of the left lung and

aorta due to a gunshot wound in the left chest.

School Meals Service

There has been little change in this service apart from the im- provements which have continued to be, made in some of the school kitchens.

At the end of the year 360 children (2.9% of the school popula- tion) were receiving meals at the expense of the Education Committee as compared with 361 (2.9%) in 1959. The number of children taking school meals was 7,971 (64.82% of the school population) compared with 7632 (62.08%) in 1959. A total of 7878 (64.06%) were having school milk compared with 8019 (44.9%) in 1959.

6 28a

Page 47

New entrants to the staffs of school canteens are examined by the Department’s Medical Staff. During the year 75 new entrants were examined and in each case a certificate to the effect that the examinee was fit to work in the School Meals Service was forwarded to the Divisional Education Officer.

Youth Employment Service

There is close co-operation between the School Health and Youth Employment Services. The medical records of all school leavers are considered by the School Medical Officer before the pupils are inter- viewed by the Youth Employment Officer and types of work for which any child is, in the opinion of the Medical Officer, unsuited, are pointed out.

During the year recommendations were made that 55 children should not be employed in one or more of the following categories of work.

1. Heavy manual work... 25 8. Work involving _ pro- longed standing, much walking or quick move

2 Work at 2... 8 ment from place to PNAS ne ott. alice ioe 18 3. Work involving _ nor- mally acute vision ... 19 9. Work in a dusty atmos- cree en ace 9 4. Work involving much 10. Freedom from damp SLOOPING 5 hands or skin defects 5

5. Work involving normal 11. Work in a damp atmos-

talons vite Childeen 98 DOT hee 2 12. Exposure to bad 6. Work involving Normal WeathGt® 6 EM ihe 4

13. Work involving — the

normal use of hands 1 7. Work near moving

machinery or moving 14. Work involving wide vemieies: for. ts. 12 ranges of temperature 4

The more seriously handicapped children are recommended to

the Youth Employment Officer for inclusion in the Disabled Persons Register.

In connection with the Employment of Children Bye-Laws, 93 children were examined as regards their suitability for employment outside school hours. Certificates were granted for employment as follows Newspaper delivery ............ 91 O25... 2 Handicapped Pupils Facilities for the special educational treatment of all classes of handicapped pupils requiring residential care, except those classed as

Educationally Sub-normal, are now fairly readily available.

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Page 48

During the year 100 pupils have been examined with reference to their need of special educational treatment, and recommendations for the provision of same were made in 70 cases. During the year 42 child- ren were removed from the register as no longer requiring special educa- tional treatment, or because they were over school age.

At the end of the year 227 pupils were included in the register, the sub-division into the various classes being as follows:—

Maladjusted tek eames » O “Pyare > Partially Cal tomy tee Physically Handicapped .... 21 Goreng: ee Educationally Sub-normal ... 161 dan att tn a Epileptic cee me Sine. tel cease dear —— Total 227 Partially 4 wae

At the beginning of the year 55 children were in attendance at Special Schools and 18 children (10 educationally sub-normal, 3 delicate, 1 physically handicapped, 1 partially deaf, 1 epileptic, 1 blind and 1 delicate) were admitted during the year. There were 12 discharges (3 delicate, 5 educationally sub-normal, 1 partially deaf, 3 physically handicapped), leaving a total of 61 children in attendance at Special Schools at the end of the year, the details being as follows:—

Category No. Away Location of Special School Blind 2 1 at Yorkshire the Blind, York. 1 at Royal Normal College for the Blind, Shrewsbury.

Partially Sighted 4 1 at School for Partially Sighted Children, 3 Fulwood, Preston. 2 at Exhall Grange School, Nr. Coventry. ‘St. Vincent’s School for the Blind, Liverpool.

Deat 11 2 at Lawns House School, Leeds. I 2 at Royal Residential School for the Deaf, Manchester. 3 at Odsal House School for the Deaf, Bradford 4 at Yorkshire Residential School for the Deaf, Doncaster.

Partially Deaf 4 3 at Odsal House School for the Deaf, Bradford.

1 at School for the Partially Deaf, Liverpool.

Delicate 3 1 at Ingleborough Hall School, Clapham. t at Children’s Convalescent Home, West Kirby.

1 at St. Katherine’s Home, Ventnor,

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Page 49

Educationally 27 6 at Royd Edge, Meltham.

Sub-normal 6 at Springfield Special School, Horsforth. 2 at Woodhouse Hall Day Special School, Huddersfield.

5 at Chaucer Street Special School, Oldham. 3 at Rossington Hall School, Doncaster. 3 at Whinburn Special School, Keighley. 1 at Hilton Grange Special School, Bramhope. 1 at Hatfield Hall, Wakefield.

Epileptic 1 Lingfield Special School. Physically 7 3 at Holly Bank School, Huddersfield. Handicapped 1 at Halliwicks Cripples School, London.

1 at Welburn Hall School, Kirkbymoorside. 1 at Scottfield Special School, Oldham. 1 at Bethesda Special School, Cheadle.

Maladjusted 2 1 at Nortonthorpe Hall, Scissett. 1 at Larches House, Preston.

There were 7 physically handicapped children who were receiv- ing special educational treatment in ordinary schools, where they were considered to be suitably placed.

At the end of the year 29 pupils in the following groups were awaiting placement in Special Schools or Hostels:—

Educationally Sub-normal _... oe oe se 26 Deaf a: a a5 1 Delicate 1 Speech 1 Total 29

The Children’s Home, The Leas, Scholes

This report on ‘“‘The Leas’’ Children’s Home is for the year ended 31st March, 1961.

During this period the staff position improved and at the end of the year, the Home was fully staffed, all six cottages were scaupied, and 82 children were in residence.

Arrangements for the medical care of the children have con- tinued as described in previous reports.

Five children were attending special schools for the E.S.N. at the end of the year, and two children were attending the Group Training Class at Kirkburton.

Five children left school during the year and were found employment.

Nortonthorpe Hostel for Maladjusted Boys The purpose of the Hostel is to provide a stable and pleasant background for socially insecure children and so enable them to mature and eventually return to their homes without breaking down.

At the end of the year 22 boys were in residence at the Hostel,

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Page 50

Reports to the Local Health Authority: Education Act, 1944, Section 57

During the year one child was reported to the Local Health Authority as ‘‘ineducable’’ under Section 57(3). In addition 10 children were notified to the Local Health Authority under Section 57(5) as likely to require ‘‘Care and after leaving school.

Medical Examination of Teachers and Entrants to Courses of Training

During the year, 49 candidates (21 male and 28 female) for entry into Teachers’ Training Colleges were examined and reports submitted to the appropriate College Authority. In addition, 18 reports on Form 28 R.Q. regarding the new entrants to the profession were forwarded to the Ministry of Education.

Liasion with Hospitals and General Pactitioners

Cordial relations exist between staffs of the School Health Service, the Hospital Service and the General Practitioners. Information is passed and mutual assistance is given to the general benefit of the children of the area.

HEALTH VISITING

Shortage of qualified staff still remains a major problem, the position at the end of the year being 5 health visitors below establishment. This is a serious position when so much more is expected of the health visitor.

Health Visitors, because of their close contact with their families, should be the first to recognise the early signs of mental stress and domestic disturbance within the family circle and be in a position to set the machinery in motion for preventing irreparable damage. This is quite impossible under present circumstances for the many other duties the health visitor is called upon to carry out leave her very little time for concentrated home visiting. Four part-time assistant health visitors are engaged mainly on clinic duties only.

Student health visitors from Leeds and Manchester spent several weeks on the division gaining rural experience. The students are always welcome, but it is regretted that the number had to be curtailed because of the lack of qualified staff.

No Health Visitors attended an outside Post-Graduate Refresher Course this year, but four attended The County Adult College at Grantley Hall, Ripon, for the three day course which is held there each year for Health Visitors.

In spite of the shortage of qualified staff, by having been relieved by the assistant health visitors of some of the work not requiring their skilled attention, the total number of effective visits shows an increase of 4,821 on the figure for 1959. Particulars are given in the following table.

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Page 51

Expectant (|Children under Children I Other

Mothers 1 year of age

District

Visits I Visits I Visits I Visits

First I Total I First I Total

Between Ages I Cases

I I Total I 1—2 I 2—5 I Visits I

Colne Valley 134 177 354 2807

Denby Dale 45 53 415 505 Holmfirth 16 66 275 1978 Kirkburton 138 dap 251 2942 Meltham 33 43 132 839

Saddleworth oe 36 205 1649

1159 I 1558 I 4184} 9885 150: 1794 669 I 1110 I 1807 I 5630 1460 } 1553 I 2217 I 8497 1. 1. 600 || 2638 829} 833 I 1158} 4505

The visits shown in the above table include 8,902 of a non-

oe 700 I 1329 I

4715 5982 I 10829 I 32046

routine nature, an analysis of which is as follows:—

Premature Babies Stillbirths Infant Deaths

Infectious Diseases

Care and after care:— Tuberculosis Patients Tuberculosis Contacts ... Discharged from Hospital Others Post Natal

Home Help Service Aged Other Visits Special Visits (not homes)

Health Education

38 3 4 36 976 252, 174 Ze 91 —— 1705 3163 2661 682 608 8902

The Health Visitor is a very privileged person in this field as she can carry her health teaching into the homes. This she is continually doing and in addition gives group talks in the clinics and in co-operation with the midwife, gives talks on mothercraft to expectant mothers at the relaxation classes. A film projector is available on loan from the

Divisional Health Office.

Health Visitors have given a number of talks to Young Wives’ Groups, St. John and British Red Cross Units, Darby and Joan Clubs, etc.; every opportunity is taken of teaching positive health,

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Mother Clubs

There are now two clubs — one at Lepton and one at Saddleworth. Both are quite well attended and the members enjoy social events, visits to places of interest and lectures on various topics.

Care of the Aged

As will be seen from the Section on the Home Help Service, the number of patients receiving the services of a home help are in the over-85 age group. These old people are visited regularly and as frequently as the Health Visitor can do so.

Hospital Liaison

Whilst there has been no alteration in the general pattern of liaison work during the year, there has been a gradual increase in volume. Three Health Visitors are now engaged on this work, one Health Visitor visits Princess Royal Maternity Hospital weekly, one visits the Almoner of the Geriatric Unit at St. Luke’s Hospital and one continues with Diabetic Care and Aiter-care. The latter continues to increase and is now almost a full-time appomtment. For an experimental period this work was divided between two Health Visitors but the arrangement was not satisfactory, either from the point of view of the Consultant or the patients and a return has been made to the arrangement whereby only one Health Visitor does this work.

Closer relationship with the staff of the Geriatric Unit at St. Luke’s Hospital, Huddersfield, is gradually being developed in spite of occasional complaints that patients suitable for transfer to Part III Welfare Homes are not found accommodation when fit to be moved.

Rehabilitation and after-care has been provided for a number of patients.

Requests for reports on the home circumstances of applicants for maternity accommodation continue to be received and in almost every

instance the recommendations made are accepted by the hospital authorities.

PROBLEM FAMILIES

The arrangement for the two Co-ordinating Committees for the care of children neglected or ill-treated in their own homes have continued on the lines detailed in previous reports.

The Saddleworth Committee met four time during the year with an average attendance of 9 members. A total of seven families were discussed, one of which was removed from the list as improved.

Eight meetings of the Huddersfield Committee were held with an average attendance of 14. During the year a total of 45 families were kept under review, 15 of them being new cases. Eleven families were

removed from the list (4 improved, 5 left the district and 2 for other reasons).

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In addition to discussions regarding individual families, the Committee have spent much time corGidering the general question of problem families and neglected children. Several members have expressed a feeling of frustration when dealing with families with reasonable incomes but where the father refuses to accept responsibility for the family when he is often quite capable of doing so. To achieve any success in such cases, some form of compulsory power appears to be necessary. Most of the families on the list can be described as ‘‘mismanaged’’, there being very few cases of serious neglect or ill-treatment in the area. How far one is justified in taking “‘into care’’ children who appear to be reasonably well nourished and not badly ill-treated, but who are dirty, ill-clad and living in squalid conditions, is a question on which there is most difference of opinion amongst social workers.

HOME NURSING

At the commencement of the year 6 home nurses and 13 nurse- midwives were engaged in the Division. During the year 2 nurse-midwives resigned their appointments whilst 3 nurse-midwives were appointed. One home nurse was redesignated home nurse /midwife.

At the end of the year the staff consisted of 5 home nurses and 15 nurse-midwives.

Particulars of the work done in the various districts by the home nurses and nurse-midwives are shown in the following table. The amount of work done by the home nurses still varies considerably and further readjustment of districts is required as soon as this can be arranged.

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ee

a a

Home Nursing Midwifery

Trans- New I Visits |Confine -| Visits fers |Patients Paid ments Paid COLNE VALLEY URBAN DISTRICT Goleary i. ny 5. oF 113 2,549 36 1019 Linthwaite be ee Sadi AO 155 3,109 13 408 Slaithwaite ope ws vs 34 100 3,779 24 827 Marsden A ay. 296 139 2,664 28 852 127 507 12,097 100 3106 DENBY DALE URBAN DISTRICT Skelmanthorpe a 61 60 1,892 29 658 Emley and Clayton West ise 22 68 2,477 4 642 Denby Dale, Cumberworth and Scissett an 45 41 2,050 17 593 98 169 6,419 58 1,893 HOLMFIRTH URBAN DISTRICY Holmfirth in 5 ih 35 100 1.923 25 768 New Mill so 3 17 66 1,445 I Loong 656 Honley on ee ote 35 96 2,051 3 108 87 262 5,929 416. 1532 KIRKBURTON DISTRICT YS 2S ee ee — Flockton, Grange Moor, Kirk- DUrtOR I sa sn wi Si, Liat? 2,344 16 I 459 Lepton, Kirkheaton ... iy) I 26 42 2,321 17 774 Shelley, Shepley er a 30 57 3,593 24 840 I 64 261 8,258 57 2,073 MELTHAM URBAN DISTRICT I I lo Meltham . re Mia io ie 78 1,927 8 425 SADDLEWORTH URBAN DISTRICT Scouthead, Springhead, Lyd- I I gate, Austerlands and Grotton il 6 1,639 32 635 Greenfield, Grasscroft, Denshaw and Delph : 62 I 408 3,755 14 609 Uppermill and Diggle ... ae 9 23 699 1s Tes 82 207 6,093 64 1,959

Total for Division 474 1484 pois 333 10,988 I

Page 55

THE HOME HELP SERVICE

There has been no change in the organisation of the Home Help Services or in the conditions whereby the services of a home help can be allocated to a household, full details of which were given in my report for 1954.

The authorised establishment of home helps is 34 and the number employed, expressed on a full-time basis, was 33.40, This is an increase of 1.87 compared with the year 1959 and the number of hours employed shows an increase of 4,274.

There was a decrease of 4 in the number of maternity cases attended but an increase in the number of cases attended in all other categories. The most marked increase both in the number of cases and hours worked was to the chronic sick, aged 65 and over.

Some difficulty has been experienced during the year in that in some parts of the Division it has not been possible to recruit the right type of person. There is no shortage of alternative employment and applications for home help work tend to come from mothers of young families willing to work within school hours. This results in frequent absences during school holidays or when the children are sick, often at short notice, when no other home help can be made available and patients are left without help.

The number of cases provided with home helps was 525 as com- pared with 472 in the previous year. The duration of assistance provided was as follows:—

ete ed Ae Bev art ele em oem Ss 2 ae as oS _No. of cases provided with the services of a Home Help for: ] Under 3—6 6—9 Over 1 Month _ Months Months Months 9 Months TOTAL 92 69 58 44 262 585 5)

Details of the assistance given to the 525 patients in the various categories are as shown in the following table:—

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38a

Colne Valley

Category No. of

Pat- ients

Av. No. of hours per Patient

Maternity (in- cluding Expect-

ant Mothers) ... 9 67.83

Tuberculosis... 1

Chronic Sick ... (over 65) (under 65) ...

30.00

75 10

142.38 169.40

Others 191.30

eco woe

Total

Denby Dale Hoimfirth

I No. of I Av. No. Pat- I of hours I per I

Patient _

I No. of I Pat- I ients

ients per

Patient

Av. No. of hours

Kirkburton Saddleworth

ee, I

No. of I Av. No.

I I of hours I Pat- I of hours I I

per Patient

Pat- ients per ients I

per Patient

76.75 7 49.85

142.03 136.25

68 115.60

172.31

D

86.00 11 101.63

94

I I I I I I I I I I I I I I I 113.89 I

tt 59.22 3 57.66 13 50.11

132.00 54.00

89 10

194.48 179.70 7

168.61

188.50 5 194.50

179.96 6 141.16 12 54.50

No. of I Av. No. I of hours I

I Patient

179.2 143.60 110 ao

I I I I I I I 142.04 79... I I I I I I I I I

No. of Pat- I ients per Patient

n 1] = Oo. . dnd

367 48

Se SC

in Te) LO = m= I Te) N iO

I I I I

Page 57

CHIROPODY SERVICE

The scheme for the provision of a free chiropody service came into operation in February, the under-mentioned persons being eligible for treatment :—

(a) the aged (i.e. persons of pensionable age)

(b) the physically handicapped (i.e. persons suffering from a handicap which is directly associated with the need for chiropody, or a handicap which in itself would prevent them from attending to their own feet, e.g. the blind).

(c) the expectant mother.

Several of the Voluntary organisations who were providing a chiropody service prior to the introduction of the County Council scheme agreed to continue to undertake the service on behalf of the County Council.

The service is normally given at Treatment Centres but when a patient is medically unfit to attend a Centre, arrangements can be made for treatment to be given at home.

Direct service treatment centres are now established at Golcar, Slaithwaite, Denby Dale, Holmfirth, Honley, Kirkburton, Kirkheaton, Lepton, Meltham and Uppermill, whilst treatment, centres are conducted by voluntary associations on behalf of the County Council at Delph, Denshaw, Greenfield and Marsden.

Generally speaking, no serious difficulties have been encountered and the service appears to be adequate for the needs of the Division.

During the period from the commencement of the scheme to the end of the year, 977 patients had made 3,412 attendances at Treatment Centres and 326 patients had received 1,109 domiciliary visits. Particulars are as follows:—

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Clinic I Domiciliary

Patients I Attend- Patients I Attend-

I ances I ances I I (a) By Direct Service I I I I I COLGAN tise athe eet ens Raha Weal I ttl [= I I I Meee ip Se 70 Slaithwaite Lome ae I I Denby Bate 2... Sr 49 I 152 - 131 I I We MELOHMU CU Rete see I Meo I 4 I I OF I PW Oe Rails 199 rifao mee I 40 I 126 || I 7 I I I Kirkburtom eae. I 60 I 30 I 105 I I I I I cae oes ean cis a2 - os 18 I — I — I I I I echoes nue ee pas I 52° I 146 I id. wee I I Melia cuss I WA 460 BF 72 I I I I Upperm fly Oi) io 86 332 I 20)" 64 I I Chiropodists’ Surgeries .......-5 I 24 or > ee a (b) By Volutary Associations I I I TSN cao eine cal 72 328 Wack oi BE I I I we FOG 10 45 I I I 5.2 wos asinine 32 127 4 20° 3 70 I I SCT ig gap ce ss oda tb 62 I 35 I 138 I I I I GG ee le O77 ep BID ek eG DO

ea, National Assistance Acts, 1948-1951

Under Section 47 of the National Assistance Act, 1948, a local authority may take action to secure removal to suitable premises of persons in need of care and attention.

Action was taken during the year in two cases, the particulars being as follows:—

Mrs. A. E. A. — This patient was a widow of 68 years of age and lived alone. She had had considerable help fom the Health Visiting Service and also from the Local Public Health Department but gradually the conditions under which she lived deteriorated to such an extent that removal became imperative. She had a reasonable income including a pension from her late husband’s employer, but she had no idea how to spend her money. Action was finally precipitated by the fact that she was without fuel in the depth of winter and even when some was provided she burnt it within two or three days of delivery. Action, therefore, was taken under the Act and an Order obtained for her admission to Part III accommodation where she settled quickly and is still resident.

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Mr. A. T. — This patient who was 66 years of age lived alone and had been suffering for some time with Chronic Bronchitis and Emphysema. He had been visited regularly by the general practitioner, district nurse and health visitor but developed myocardial failure and refused to go into hospital. His condition deteriorated and later his legs became very oedematous, although he was receiving treatment for this condition. As a result of this, application was made under the ’51 Act for his removal to hospital where he died three weeks after admission.

Ambulance Service

_ During the year close co-operation has been maintained with the Superintendent of the Huddersfield Depot and any difficulties of a medical nature arising have been discussed.

The Service has worked smoothly throughout the year and complaints have been negligible.

During the year the ambulances from the Huddersfield Depot travelled 148,042 miles, and carried 18,287 patients, 2,827 of these being stretcher patients. Included in the 18,287 patients carried were 14,106 hospital out-patients. Particulars of the cases carried are given below:—

Our Patients ... me ahs ee Res =, L406 Admissions ae ek a oe Discharges a oe ae ne vex, NSS Transfers oo pe. ae ve des 885 Accident Patients a Ee i fe a7 18287

In the Saddleworth Area arrangements with the Oldham County Borough Ambulance Service have continued.

During the year ambulances of the Oldham Service made journeys involving 17,899 miles and carried 2,219 patients and in addition journeys involving 31,701 miles were made by Sitting Case Cars on behalf of 3,685 patients. Of the patients carried 180 were classed as accident cases, 232 emergency cases and 5,492 others.

MENTAL HEALTH

The coming into operation of the whole of the Mental Health Act, 1959, has increased tremendously the responsibilities of the Local Health Authorities in this field. The County Council have made extensive plans to deal with the problem and these are gradually being put into operation. Mental Welfare Officers are being appointed but at the end of the year only Mrs. M. Moore, former Mental Health Social Worker, was available in the Division. The former Duly Authorised Officers, however, continued to give help with the removal of patients to hospital.

During the year one child was reported by the Local Education Authority under Section 57 (3) as ineducable and 10 under Section 57 (5) as requiring supervision after leaving school.

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Page 60

At the end of the year the number of patients under care was as

follows:— MALE FEMALE TOTAL

Under 16 and Under 16 and Under 16 and

age 16 over age 16 = over age 16 = over Mentally ill — 16 — 35 — 51 Psychopath. — — — — — — Subnormal a 51 5 30 12 101 Severely subnormal] ... 9 18 7 18 16 36 TOTAL 16 85 12 103 28 188

Approval has been given for the erection of a purpose built Training Centre and at the end of the year negotiations were in hand regarding the site and plans.

The Group Training Centre at Kirkburton has continued to flourish and meets on five days each week. There are 35 places available and the training is given by the home teachers. The number of patients attending and the number of attendances made during the year were as follows :—

Average No. of No. of No. of Number of Sessions Patients Attendances Attendances

per Session

464 33 10,046 21.65

There is no doubt that the facilities provided at the Centre are much appreciated both by the patients who attend and their parents Since the adaptations and re-decorations were completed the premises have been very convenient and attractive. One difficulty has been to find suitable occupation for the older patients but it is hoped to start more creative handicrafts such as stoolmaking, in the near future.

Staffing has been:somewhat of a problem during the year but was up to full strength at the end of the year.

The Social activities during the year included a trip to Southport and a Christmas Party at the Kirkburton Centre. These were well attended by patients from all parts of the Division and were thoroughly enjoyed.

Through the kind co-operation of the Huddersfield and Oldham County Borough Authorities, a few vacancies at Training Centres run by these Authorities have been made available for West Riding patients and at the end of the year two patients were in attendance at the Scarleigh Occupation Centre, Milnsbridge, and two at the Oldham Occupation Centre. In addition, five patients were attending the Oldham Industrial Centre.

Although it was still unusual at the end of the year for patients on discharge from the principal mental hospital serving this Division to be referred for after-care, contact with the hospital has increased and information about patients is readily available on request.

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A few requests have been received from the Consultant Psychiatrist for after-care for patients living in the Saddleworth Area on discharge from the Annex of the General Hospital in the adjacent County Borough.

The majority, however, of patients for whom after-care is provided have come to notice through other agents such as general practitioners, health visitors, welfare officers and officers of the National Assistance Board.

Medical Examination for Superannuation Purposes

New entrants to the County Service are required to undergo a medical examination to see if they are suitable for admission to the Superannuation Scheme, and these examinations have continued to be carried out by the Department’s medical staff. During the year 85 such examinations (43 male, 42 female) were carried out.

In addition 5 members of the County Staff (3 males, 2 females) were examined to ascertain whether or not they were incapable of discharging with efficiency the duties of their employment by reason of permanent ill-health.

43a

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