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The accompanying table gives some idea of the additional work
thrown upon the Public Health Department, and which has now
still further been increased by the inclusion since 1913 of all forms
of tuberculosis other than that of the lungs. It is necessary also,
besides arranging for the regular visits to the greater proportion of
those notified, to see that any advisable disinfection of premises
when patients have removed is carried out, to keep and check the
accounts (no light matter), and to see to numberless other details.
This has been well done, and in the main by Messrs. Wright
and Wooldridge, but all the other clerks have occasionally been
compelled to lend a hand. If the work should increase, as it shows
every likelihood of doing, we shall require more assistance.
The number of which all trace has been lost may appear large,
but it refers not only to cases notified in 1912, but to those of previous
years who were still to be visited last year. It is not improbable
that the ignorance of the whereabouts is pretended and not real,
although in not a few instances enquiries elicited the fact that
there were others who were anxious to know the address, but
for reasons altogether different from ours.
As set out in Table III. there were 339 deaths in the Borough,
and of these 16 had not been notified. The subject of non-notification
was reported to the Committee, and they have decided that
in each case where a death has been registered as due to tuberculosis
and where a notification has not been received that I
should write to the medical attendant and ask for an explanation.
This is now done, and the explanations duly given to the Committee,
No one has as yet been prosecuted in this Borough for omitting
to notify.
The amount of segregation of the advanced cases which is not
compulsory has been attracting much attention, and part of the
diminution in the mortality from phthisis has been ascribed to it.
Of the deaths which occurred in infirmaries and other public institutions,
which were 172 in number, 28 had been inmates less than a
week, 27 had been there more than one week and less than a month,
51 had been there more than one month, and in 32 other instances
the patient had been in some institution but had come out before
his death.
A temporary Committee was appointed after the coming into
force of the National Insurance Act in July to make provision for
the domiciliary treatment of insured persons suffering from consumption.
A difficulty arose in the case of a man who was unable
to provide for his own lodging, and at one time it seemed necessary,
despite his own wish, that he would be compelled to go into the
infirmary. Up to the formation of the permanent Committee
arrangements were made by the Public Health Department of this
Council, naturally entailing additions to the work already increased
by the notifications. In addition to this, I was asked to draw up a
scheme of fees and charges to be defrayed by the Committee in
cases where treatment in a sanatorium was considered undesirable
for the patient, and he is recommended for domiciliary treatment,
that is, for him to be attended at home by his own doctor. Those