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55
the managers of any hospital, for the reception of the sick
inhabitants of the District. Under Section 77, the Council
may, (with the sanction of the Local Government Board)
themselves provide, or contract with any person to provide,
a temporary supply of medicines and medical assistance for
the poorer inhabitants of their District.
Further powers are conferred by Section 82, but these
are only operative when certain regulations known as the
" Epidemic Regulations " are issued by the Local Government
Board. None of these powers except the last is
compulsory upon Borough Councils, and no penalty can be
inflicted for failing to put them in force.
The Public Health (London) Act has been in operation
for twenty-one years, and I know of no instance where
Sections 75 and 77 have been put in operation beyond the
contracting with Sanatoria and Hospitals, such as we have
already done with Fairlight.
The Sections were, I believe, included in the Act with
a view of meeting any sudden epidemic, such as Plague or
Cholera, which could not be adequately dealt with by
existing Hospitals. It is highly improbable that it was ever
intended that Metropolitan Borough Councils (the old
Vestries) should enter into competition with existing
Hospital Authorities for the treatment of general disease;
and twenty years ago Pulmonary Tuberculosis was not
recognised as communicable. Notwithstanding this, the
clauses undoubtedly confer upon Borough Councils the
powers to erect Sanatoria should they think fit to do so.
Article IX. of the Local Government Board's Regulations
previously referred to, is on quite a different footing. It is
not confined to London, but applies to the whole of England
and Wales. It was drawn expressly to authorise Borough
Councils to undertake the treatment of disease in addition
to preventive measures, and though an Anti-Tuberculosis