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42
Parish of St. George the Martyr, Southwark.
had been sixteen years in your service, so that he might reasonably have been expected
to have a knowledge of his work that would enable him to act independently - of any
written instructions. So far as I can learn, only some three or four of the Metropolitan
Medical Officers of Health have given anything but verbal instructions to disinfectors.
Then, again, the Health Committee has constantly recognised the direct relation of
Sanitary Inspectors to Disinfectors by appealing to Mr. Edwards upon points raised at
meetings with regard to disinfection. For instance, on 12th October, 1896, the question
as to the need of additional help for the disinfectors was asked of Mr. Edwards,
although I was present at the time, and, I may add, held entirely different opinions
from those put forward by your Chief Inspector. In an office like, mine, where these
is an enormous amount of detail to consider, it would be obviously impossible to attend
personally to every detail of administration, such as a visit to each notified case. But
while the superintendance of disinfection has been in the hands of the Inspectors during
the period covered by the Report of the Sub-Committee, I have had no coniphiints about
errors of disinfection from the Chief Inspector, through whom such complaints would
reach me. In making these plain statements, I do not wish to shirk any technical
responsibility as head of the sanitary department. At the same time. I cannot accept
the whole responsibility which the Report appears to assume lies upon my
shoulders. Nor do I wish to cast any slur upon my Inspectors, who, I believe, have on
all occasions acted loyally by their Medical Officer.
To sum up this part of the subject. So far as I can learn, the present disinfector
has been under the direct control of the Sanitary Inspectors for the last'twenty years.
During the four and a half years I have held office he has certainly remained under that
control. He has received his orders from the Chief Inspector, Mr. Edwards. The
Vestry have recognised that position. Lastly, until the Subcommittee's Report, 1 have
had no reason to imagine that any other view of the matter could possibly be taken.
The Report quotes that Section of the Sanitary Officer's Act which directs the
Medical Officer of Health to visit the site of any outbreak of dangerous infectious
disease. I may point out that the interpretation of the word "outbreak" is left
entirely to the judgment of the Medical Officer, a point insisted upon by the Local
Government Board. In my opinion, ten cases of scarlet fever in Pardoner Street,
spread over a period of three weeks and two days, did not warrant the description of
an "outbreak." That view was evidently shared by Dr. Smith, who acted as my
Deputy during part of the time in which these cases occurred. I may add that by
my directions the Sanitary Inspectors visit and take down on a printed form numerous
details in every case of notified infectious illness.
Under Section (50 of the Public Health Act, the Health Committee, upon receipt
of a certificate from the Medical Officer stating that cleansing is necessary in a given
case, must issue a notice to the owner to undertake the requisite work. Failing action
on the part of the owner within twenty-four hours, the law directs the Vestry to
perform the work at their own expense. The cleansing must be done to the satisfaction
of the Medical Officer. It is, therefore, left to the individual Medical Officer to
decide what is necessary, and whether stripping the paper and white-liming is wanted
for proper disinfection. When I came to this parish in 1892. I found that Dr. Walter
Smith, who acted as Deputy Medical Officer when the new Act came into force,
ordered the paper to be stripped in a scarlet fever case. The cost of that particular
cleansing was thirty shillings, which was paid by your Health Committee, but I was
informed that the then chairman, Mr. Brazier, with the approval of members present,
expressed his opinion that such costly work should not be carried out in future. With
that information in view I have refrained from taking action under the Section
mentioned. I may add that on several occasions I have brought this matter before
the Committee.
2. Suggested Remedies.—The recommendations at the end of the Sub-Committee's
Report would certainly meet the approval of almost all Medical Officers of Health.