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40
It has been stated that Sanitary Authorities and Boards of Guardians
consist in many places of almost the same members. This is, to a certain
extent, true ; but the members who sit on these Bodies are always careful to
confine their duties within the scope of their powers; and even if they desired
to go beyond them, the Clerk of the Body would quickly check any such
illegal action. So that the prevention of Small-pox is and always must
remain divided so long as one part is in the hands of one Authority, and
another part of another, and courtesy frequently prevents one Board from
criticising, advising, or stimulating another Board, the effect of which is not
beneficial to smooth working of what should be one homogenous system of
prevention.
Vaccination means and methods could be immensely improved, and the
opposition to it mitigated, if not entirely removed, but no improvement has
taken or is likely to take place, so long as it is administered only for paupers,
and the general public has to submit to a pauper system.
Guardian Boards have no special Officer to report upon such a subject as the
prevalence and prevention of Small-pox in the community, and even if the)had,
the Officer would not be in possession of sufficient information upon the
subject.
It must be obvious that, however conscientious a Board of Guardians may
be, they cannot possibly be so well acquainted with the requirements to
prevent or meet an epidemic as the Sanitary Authority; but Boards of
Guardians necessarily differ in conscientiousness.
It has happened over and over again that Sanitary Authorities have found
it necessary to remind Boards of Guardians of their responsibilities and duties
with regard to vaccination (see also Lancet, May 2nd, 1896, p. 240). The
Public Health Committee of the Ipswich Corporation in the last week of
April, 1896, alarmed at the neglect of vaccination in the Borough, drew the
serious attention of the Board of Guardians to the risk being incurred. In
Gloucester, in April, 1896, the Town Council found it necessary to remind
the Board of Guardians that they were not by any means doing sufficient
vaccination to stay the Small-pox epidemic, and engaged a dozen medical men
to make house-to-house visitation and vaccination throughout the City. In
Warrington, during the epidemic of Small-pox in 1892-3, the Health Committee
had to take up the duty legally devolving upon the Board of Guardians
and to open five extra vaccination stations and provide extra vaccinators.
The responsibility, not only for stemming an immediate epidemic, but also
for preventing a future epidemic, should be placed upon the Sanitary Authority.
Accusations, on the one hand, that it is due to the insufficient provision of
hospital accommodation, and, on the other, that it is due to insufficient
vaccination, could not then be made by one public body against another.
Sanitary Authorities have notified to them all cases of Small-pox, and
consequently are immediately acquainted with the extent and locality of
outbreaks, and know when and where vaccination is most urgent.