London's Pulse: Medical Officer of Health reports 1848-1972

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London County Council 1956

[Report of the Medical Officer of Health for London County Council]

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4. Housing
(a) Statutory overcrowding.
(b) Living in intolerable conditions (while not overcrowded) because of either lack
of amenities such as piped water, damp or insanitary conditions and/or enmity
of other occupants of dwelling.
5. Poverty and mismanagement
(a) Chronic family debt.
(b) Lack of minimal necessities of furniture and bedding.
(c) Inadequate and irregular meals.
(d) Domestic filth and disorder.
(e) Wilful damage to property.
(J) Lack of or inadequately maintained clothing of children.
6. General
(a) Unnecessary crowding at night.
(b) Gross personal uncleanliness.
(c) Failure to take advantage of necessary help and service proffered.
(d) Child or children taken into care other than as the result of court action, and
who are frequently taken into or out of care.
Allocation of points to factors
1. One point was allotted for the existence, whether one or more persons was
affected, of each factor in the list except:
(a) items 1 (a) to (/) where the pointing was
for one parent .. .. .. .. .. .. 1 point,
for both parents or the sole parent .. .. .. 3 points
(b) item 1 (j) when the pointing was
for one parent .. .. .. .. .. .. 1£ points
for both parents or the sole parent .. .. .. 4 points.
2. Additional points or fractions of points up to a maximum of 5 could be added
by the reviewing officer to deal with imponderable factors not listed, e.g., persistent
sickness of children; mental or physical cruelty of one parent to another; racial differences
between parents; spasmodic reappearances of deserted, divorced or separated
parent (which upsets stability) ; a combination of items which do not of themselves
merit points such as domestic disorder (without filth), poverty with spasmodic debt,
large numbers of children under 5 and inadequate (but not irregular) meals.
3. The maximum pointing was 56 and for the purposes of classifying the families
assessed the following arbitrary values were used :
Hardcore problem family—11 points or more.
Potential problem family—5-10 points inclusive.
The differing social conditions in various parts of the County and the lack of any
real knowledge of the numbers and location of problem families made it necessary
to have a complete survey rather than a sample. At the end of the planning stage the
nature and scope of the survey were discussed with the other departments and agreement
to conform as far as possible was obtained.
Operation
The public health department survey—The County is divided into nine divisions
each administered by a divisional medical officer. In each the health visitors were asked
to make a provisional selection of the families falling under the two heads, i.e., potential
and hardcore problem families. Family case histories selected by the health visitors,
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