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55
Annual Report of the Medical Officer of Health—1896.
It may be held necessary that, for future guidance, the Vestry should lay the whole
facts of the case before the L.G.B. and ask for their ruling in the matter.
The enforcement of Section 60 of the Public Health Act is the last point dealt
with by the M.O. in this portion of his report. Your Committee deals with this
matter at a later period.
The report concludes with suggested remedies. These are dealt with in detail in
the Supplementary Report presented to the Vestry at its meeting on January 12th.
Before its reception by the Vestry the M.O. was instructed to submit the same to
a Special Committee. With this your Committee propose now to deal. As copies
have been sent to every member of the Vestry, it will have been observed that the
doctor deals with the matter under the following heads:—
Administration of (a) Office, and (b) Household.
(a) Office. Notifications. These are received at all hours of the day. Tho M.O,
is due at 10 a.m., the Chief Sanitary Inspector and staff at 9.30. They
review the doctor's correspondence, and such letters as they think contain
notifications, they open, according to the doctor's instructions. The Chief
Sanitary Inspector sends a disinfector to the case notified, to learn if the
friends are willing that the patient should be removed. If tho answer is in
the affirmative, the Sanitary Clerk telephones to the M.A.B.; should the
friends refuse, the District Inspector visits, and, if he thinks it desirable, he
attempts to persuade the patient to be removed: if his efforts fail, he communicates
verbally with the M.O., who "usually pays a visit in person. "
Your Committee endeavoured to learn what percentage of such cases the
M.O. visited in the months of October, November, and December. The
doctor was unable to give any information, because he keeps no record;
various cases were selected at haphazard, and, on being asked whether he had
visited he could not reply for the reason already stated. From the stand
point of administration such a result Is most unsatisfactory; from the stand
point of the patients themselves it is even worse; for the statement has been
made, and not contradicted, that whenever the doctor does visit, speaking
generally, he succeeds where others fail. The doctor states that a "daily
record of notifications'' is kept, but your Committee find that such record
has not been kept entered day by day. This circumstance is to be regretted,
for reasons which are fresh in the memory of the Vestry; had the M.O.
exercised a detailed supervision, this book would have been properly kept.
A second smaller book which, since the date of the first inquiry, has been
improved, is also kept, and affords further information. But it is inadequate,
and additional colums should be provided, in one of which should be
preserved a record of the M.O.'s visits when made.
As regards the certificates of disinfection granted to employers, the Vestry, on the
recommendation of the Health Committee, has already ordered that a counterfoil
book should be prepared. As regards the notices of disinfection for head
teachers, your Committee, are of opinion that they should always be sent by
post-
In reference to the keeping of books, your Committee cannot concur in the doctor's
view that sufficient books are kept, nor are they properly systemised; nor
are they kept up to date. This is indispensably necessary if the work of
the Health Department is to be efficiently done; and furthermore, your
Committee strongly recommend that the M.O. shall be required to keep the
book indicated in Art. 18, Sec. 14, of the Sanitary Officer's (London) Order,
1891. Had this book been in existence, and properly kept, a vast amount of
time would have been saved, and unpleasantness avoided in the course of this
enquiry. If the doctor declines to keep such diary, your Committee has no