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purposes the subject of such notification should be counted
as a case of tuberculosis which has come to knowledge otherwise
than by notification under the Regulations.
2. Some difficulty appears to have arisen in connection with
the notification of cases in which tuberculosis is diagnosed by
a Tuberculosis Officer, and there is evidence that, in some
areas, cases referred to a Tuberculosis Officer by a general
practitioner have escaped notification owing to each doctor
leaving it to the other to notify. In the Minister's view the
Tuberculosis Officer should immediately notify each case in
which he diagnoses tuberculosis, unless he ascertains definitely
that the practitioner has notified, or will notify, the case.
3. It is observed that occasionally new cases of tuberculosis
are notified to the Medical Officer of Health on Form C
or Form D. In this connection attention is directed to
Article VII. of the Regulations of 1012, and that, if a notification
on either Form C or Form D is received by the
Medical Officer of Health of a district in respect of a person
whose usual place of residence is within the district, but whose
case has not previously been notified to him, he should forward
to the Medical Officer of the Institution from whom the notification
was received a copy of Form A for primary notification
of the case, at the same time informing him of the circumstances
and asking that a notification on that Form may be
furnished.
4. As a result of a comparison made between the totals of
the notifications of tuberculosis, as furnished by District
Medical Officers of Health to the Registrar-General during
1923 on the Weekly Returns of Infectious Diseases, and the
total of the primary notifications as furnished to this Office
in the Annual Returns of the Medical Officers of Health of
Counties, County Boroughs and Metropolitan Boroughs, it
has been found that in many areas the two sets of figures
show a wide divergence. It should be understood by District
Medical Officers of Health that, so far as tuberculosis is concerned,
whilst the weekly return required to be furnished to the
County Medical Officer of Health under Article XI (3) of the
Regulations of 1912 should include a statement of every
notification of tuberculosis received by the District Medical
Officer of Health during the week, whether primary or duplicate,
the figure to be entered in the Weekly Return to the
Registrar-General should include only the Primary notifications
of tuberculosis on Form A or Form B received during
the week.
5. The Minister desired to take the opportunity of impressing
upon Local Authorities the responsibility which attaches