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46
of cases, and in view of the valuable results which have accrued, it
is a matter for regret that more cases have not been reported. The
County Council have considered the desirability of taking more active
measures in connection with phthisis, and have submitted two questions
for the opinion of the City and Borough Councils
(1) Should phthisis be declared under the Public Health (London)
Act to be a notifiable disease ; or
(2) Should steps be taken to make the system of voluntary
cation general throughout London.
The County Medical Officer thinks the second of these should be
attempted, and suggests that the hospitals and dispensaries might be
induced to notify their cases.
I have reported as follows:—
"From the experience of voluntary notification during the past
three years, I am of opinion that phthisis should be compulsorily
notifiable. The reasons which have led me to this conclusion are:—
"(a) That the various hospitals and dispensaries in the City have
agreed to notify their cases, yet the total number of notifications
which have been received have been only 123 in
1903,148 in 1904, and 112 in 1905, a very small proportion
of the total cases.
"(h) The valuable results (removal of insanitary conditions,
prevention of infection, the provision of sanatorium
treatment, of more suitable occupation and assistance to
patients' families, &c.), which have been obtained from a
knowledge of these cases lead to a desire to extend the
benefits to all cases.
(c) The prevention of consumption is a matter of extreme social
importance (large numbers of the working classes being
reduced to poverty by this disease), and local authorities
should not have to depend for information with regard to it
upon a voluntary system which limits very considerably
attempts to deal satisfactorily with it.
"(d) The London County Council has the power itself, with the
sanction of the Local Government Board, to make phthisis
a compulsorily notifiable disease, but cannot do more than
suggest to the Borough Councils that they should adopt a
system of voluntary notification. This has already been
clone by the Conference of Bepresentatives of Metropolitan
Boroughs convened by the London County Council in July,
1904, but eleven Borough Councils have not yet adopted it.
Possibly they have not done so on account of the inadequacy
cf the method.