View report page

ii
VENEREAL DISEASES.
REPORT ON THE VENEREAL DISEASES SCHEME.
I.
Introduction.
The Public Health (Venereal Diseases) Regulations, 1916, made by the Local Government Board,
required that the councils of the counties and county boroughs in England and Wales and the Common
Council of the City of London should (1), subject to the approval of the Board, make arrangements
for enabling any medical practitioners practising in the area of each council to obtain, at the cost of
the council, scientific reports on material from persons suspected to be suffering from venereal disease ;
and (2) prepare and submit to the Board a scheme (a) for the treatment at and in hospitals or institutions
of persons suffering from venereal disease, and (b) for supplying medical practitioners with Salvarsan
or its substitutes for the treatment and prevention of venereal disease.
The regulations were the outcome of the first report of the Royal Commission on Venereal Diseases
(Cd. 8189), which was issued in March, 1916. The Royal Commission found that the effects of venereal
disease upon the individual and upon the race were grave and far reaching, involving a heavy loss to the
community in actual and potential population, as well as in money. They reported that the medical
evidence given before them established the fact that, by early and efficient treatment, venereal diseases
could be brought under control and reduced within narrow limits, but that treatment was in most cases
unduly deferred and the best modern methods of diagnosis and treatment were not within reach of the
population generally. They recommended that arrangements should be made for providing free for
the whole community adequate laboratory facilities for diagnosis, combined with the provision of
adequate and skilled free treatment for all persons affected with venereal disease. They further
recommended that the organisation of these arrangements should be entrusted to the councils of counties
and county boroughs, and that 75 per cent, of the cost of carrying out approved schemes should be
met from Imperial Funds. The Government adopted these recommendations.
The principles underlying the scheme of the Local Government Board were to prevent the spread
of these diseases (a) by rendering non-infectious the greatest possible number of infection carriers
and (b) discouraging, by education and general propaganda, practices which lead to exposure to infection.
They sought to accomplish the first of these principles by the establishment of free treatment centres,
and the institution of various measures by which those centres and their auxiliaries are fed. The second
was placed largely in the hands of the National Council for Combating Venereal Diseases as recommended
by the Royal Commission.
For the purpose of carrying them out with the least possible delay, the Local Government Board
being of the opinion that the conditions at the time constituted a case of emergency within the meaning
of Section 2 of the Public Health (Prevention and Treatment of Disease) Act, 1913, made regulations
under the Public Health Acts which empowered the Board to require county councils to execute and
enforce regulations made under Section 130 of the Public Health Act, 1875, without the consent of those
authorities.
The expenses of the county council under these regulations were to be defrayed as expenses for
general county purposes, the Government, as already stated above, repaying 75 per cent, of the expenditure
incurred and approved by the Local Government Board.
The regulations were accompanied by circulars, dated July 13th, 1916, from the Local Government
Board to the authorities concerned, indicating the nature of the arrangements which, in the opinion
of the Board, should be made for the purpose of combating venereal disease. As regards diagnosis, the
facilities provided by the council were to be made available for the whole population of the area,
without cost to the patient or to the medical practitioner, for the pathological examination of
specimens sent by any doctor practising in the area.
As regards treatment, special attention was drawn to the findings of the Royal Commission that
the existing facilities were extremely deficient, that adequate institutional treatment should be available
for the whole community, and should be so organised that persons affected by these diseases should not
be deterred from taking full advantage of the facilities provided, and that this result would be best
secured by the use of the existing general hospitals rather than by setting up special institutions for
the purpose. It was also pointed out that both in-patient and out-patient treatment would be required,
and that the arrangements for the latter would form the most important part of the scheme. Moreover,
it was indicated that, in all cases, the arrangements with the hospitals should be such that the clinics
for venereal cases should not be specially designated and that nothing should be done to distinguish
the patients who attended for the treatment of those diseases. Furthermore, treatment at hospitals
must be available for all comers, irrespective of place of residence and means of the patient. The high
proportion of the Government grant was fixed in order that the facilities provided under the schemes
should be available for the whole population. It was also suggested that where the same hospital
would conveniently serve more than one area, the councils concerned should confer as to the