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routine procedure, and spittoons supplied free of cost. In addition,
hospital accommodation is provided for 35 patients, as well as a
Dispensary. The Board of Guardians have provided a Sanatorium
with accommodation for 300 patients. All patients discharged are
kept under observation by Health Visitors. Visits are paid to every
School, Dispensary, Factory and Workshop in the City, and
leaflets are distributed relative to the prevention of the disease.
In Cork voluntary notification is in operation. No spittoons
are provided, but disinfection is carried out in all cases where permission
is granted. A Sanatorium is at present being erected for
the reception of cases, for the foundation and upkeep of which a
voluntary rate is paid.
In comparing the methods which are being or about to be
carried out in the Provinces with those of the Metropolis, the
advantage would seem to be greatly in favour of the former. It
is regrettable that in London some uniform system of dealing with
this deadly disease is not carried out. In the districts of some
authorities a form of voluntary notification is in force, but in
others—e.g., Battersea—there is none. While much improvement
has been effected in recent years in the Metropolis by the individual
efforts of Sanitary Authorities, the movement has, in my opinion,
suffered from lack of co-ordination and co-operation. This is
peculiarly likely to occur in London owing to the movements of
patients from the district of one Authority to that of another.
It is of the greatest importance, therefore, that some co-ordination
of method should be in force, which can only be successfully
carried out by notification. A Conference convened by the Paddington
Borough Council, attended by representatives from
this Council, was held last year, at which a resolution in
favour of Compulsory Notification was carried. The provision
of Sanatoria for the Metropolis is a matter for the County
Council or some other Central Authority. This form of prevention
is one that is coming to be recognised by Sanitary
Authorities as the most successful method of dealing
with the disease. It is to me astonishing that greater
efforts in this direction are not made by those responsible
for the Public Health of the Metropolis. What I have indicated