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With the onset of the compulsory notification of all persons
suffering from pulmonary tuberculosis, which came into force on
January 1st, 1912, it is but natural that there would be a great
increase in the total number reported for the year, for previously to
this, notification was only obligatory in the case of persons attending
hospital or those under the care of the Poor Law medical
officers, while before May 1st, 1911, it referred to those only
in the second category. It will be noticed that there is a very
great difference between the number of persons notified and the
notifications received in respect to such, which is explained by the
fact that the same person has been seen by several doctors. For
instance: a man attended by a private doctor reaches such a condition
either of illness or means that it is advisable for him to be
removed to the infirmary. As a preliminary to this, he would have
been seen by one of the Poor Law doctors, who would have to report
the case, and a third notification would have also been received
from the doctor at the infirmary.
At the end of 1911 a small Sub-Committee was appointed to
consider what changes and additions might be called for in the staff
on account of the extra amount of work involved in the addition of
phthisis to the list of notifiable diseases.
The question of assistance resolved itself into two parts, the
first that of professional help to me, which was considered, but
adjourned and re-adjourned during the year, and the second the
necessity for increasing the clerical staff.
The idea of the Committee was rather to allow the lapse of a
sufficient period to form some idea as to the scope of necessary
alterations rather than immediately to decide on action which must
have been more or less permanent in its character. But I was
allowed to engage extra clerical assistance. Since January, 1912,
Mr. Wooldridge has been temporarily employed, and the help has
been of considerable use. In fact, without it we would have been in
a hopeless muddle; even as it is, the work was only got through with
difficulty and with the occasional working beyond the ordinary
hours.
Following the report of the Departmental Committee, much
attention has been drawn to the general provision of tuberculosis
dispensaries. Not content with the mere treatment of the patients,
the idea of these institutions is one of searching out the disease in
the homes of the persons notified, and by means of what is
technically termed a "march past" to discover any unsuspected
cases in the families, the object being to get these mild and early
cases under medical care, and to keep them under the best possible
conditions for recovery.
The Departmental Committee expressed themselves very
strongly in favour of the provision of a dispensary, and in this
they were no doubt influenced by reports they had received from
authorities and medical officers of health. In opposition, however,
to the view of the indispensable character of the tuberculosis
dispensary, it has been urged that in towns where no dispensaries