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22
Of the new eases notified in 1922:—
13 were dead or dying at time of notification
28 were patients in hospitals, sanatoria or other institutions.
3 removed from Hampstead almost immediately after
notification
4 were out-patients of hospitals
20 were attended by private doctors only
67 attended the Dispensary.
From this analysis it will be seen that just half the number of
notified cases attended the Dispensary, the rest scarcely coming within
its scope at all, though of course the action of the Public Health
Department extends to them wherever possible. I cannot but conclude
that a number of the 13 who were dead or dying at the time
of notification should have been notified earlier. Nome cases are
admittedly difficult, such as one who was a Christian Scientist, and a
general practitioner was only called in at the last moment. Still there
are some cases thai should be notified earlier, and I would appeal to
the practitioners of the Borough to see that the number be further
reduced.
with reference to the question of efficiency of notification of
Tuberculosis, the following figures pertain:—
The deaths of non-notified cases of Tuberculosis numbered 16,
and the total tuberculosis deaths 69; the ratio of non-notified
tuberculosis deaths to total tuberculosis deaths being 1 in 4.
In addition, 9 cases were first known to the Medical Officer
of Health within a period of one month of death, 7 within
three months and 1 within six months.
After careful consideration of the notifications of the past year
I have formed the opinion that from 20 to 25 per cent, of the cases
only become known to the Public Health Department upon the approach
of or on the actual occurrence of death, my experience is that the
hospitals and institutions are more to blame than the general practitioners,
and that there are certain cases in which non-notification or late notification
is excusable, such as the following:—
People arriving in the Borough in a moribund condition.
Difficult diagnosis, the actual nature of ease being found only
at death.
Doctor only called in when patient wns in extremis.