View report page

40
The practical difficulties in grappling with these large numbers
of Chickenpox cases soon appeared, and the London County
Council, on February 24th, 1902, appointed 37 medical men
throughout the Administrative County of London to act as consultants
or experts in connection with the diagnosis of doubtful
cases of Smallpox, the London County Council to pay the fees
(10s. Gd. for each case visited). The notification fee is, in addition,
1s. each certificate, the Metropolitan Asylums Board, in a
letter dated April 5th, giving the opinion that such experts act
in a public capacity as Medical Officers of a public body. This
action of the London County Council gave rise to a large amount
of ill-feeling amongst the different Metropolitan Authorities, it
being thought that such appointments, if required, should be made
by the Metropolitan City and Borough Councils concerned. As
regards Lambeth, objection was taken on behalf of the Borough
Council by your Medical Officer of Health in a letter dated
February 20th, 1902, and previously at a personal interview with
the London County Council's Medical Officer, with the result
that no experts were appointed in Lambeth. The Borough
Council protested formally on March G h, 1902. Experts living in
neighbouring Boroughs were, in a very few instances (less than
a dozen), called in in connection with doubtful cases occurring in
Lambeth Borough, and in three instances the diagnoses made by
such experts were found to be wrong—in one instance (a case of
Smallpox diagnosed by the expert as Chickenpox) 5 cases arising
therefrom, and in the others, the patients (suffering from Chickenpox,
but diagnosed by the experts as suffering from Smallpox) being
removed to the Smallpox Hospital (but fortunately sent back
at once). It is clear that such appointments of experts should be
made by the Borough Councils concerned, so that the greatest
care might be exercised in order to secure the services of only
competent men (if their services are required at all) to act under,
and be responsible to, the Medical Officers of Health. The
Society of Metropolitan Medical Officers of Health protested
officially against the appointments of these experts by the London
County Council, and thev were discontinued on November
6 th, 1902.
In Lambeth, the Medical Officer of Health acted as expert and
consultant for the Borough, and this arrangement was found to
work well, though much extra work devolved in consequence upon
such officer.
. Before leaving the subject of notification, it is only fair to state
that, speaking generally, the promptness with which the cases of
Smallpox (and all doubtful cases) have been notified throughout
the Borough calls for special mention, and that in this connection