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- give power to sanitary authorities to impart it, and still further to inculcate
that cure and prevention by means of education should go hand in hand.
Hence the legislation and Local Government Board Orders with respect to
Sanatorium and Dispensary treatment, which empower them to provide it.
What are these legal powers? And what are Tuberculosis Dispensaries,
with which London Metropolitan Boroughs only deal with?
Legal Powers to provide Tuberculosis Dispensaries.—The
question has been raised as to the legal powers of Metropolitan Borough
Councils to provide Tuberculosis Dispensaries, but I think there can be no
doubt that under section 75 of the Public Health (London) Act, 1891, they
can do so. The section is as follows:—
"Any sanitary authority may provide for the use of the inhabitants of
their district hospitals temporary or permanent, and for that purpose may
(a) Themselves build such hospitals, or
(b) contract for the use of any hospital or part of a hospital, or
(c) enter into agreement with any person having the management of
any hospital for the reception of the sick inhabitants of their
district, on payment of such annual or other sum as may be
agreed on."
In referring to this question, the Local Government Board, in their
Circular of November 16th, 1911, write as follows:—
" In a disease such as tuberculosis, the prevention of infection and the
treatment of the patient frequently cannot be separated. In certain cases it
is no doubt desirable that the local authority should be able to offer sanatorium
treatment, and for this the powers of the Public Health Act, 1875, and the
Public Health (London) Act, 1891, are available. Under these powers the
local authorities may either themselves provide sanatoria or may contract for
the use of such institutions. The Board have also been advised that these powers
also enable a local authority to provide or contract Jor the use of dispensaries or outpatient
hospitals."
It will be noticed that the Act does not say that sanitary authorities
" must " or " shall" provide these institutions, but only " may." Every person
acquainted with Acts of Parliament knows that " may." very often means
" must" or " shall." However this may be in this case, there can be no doubt
that a moral obligation, which I will not argue because it can hardly be disputed,
rests on sanitary authorities to use their powers to their fullest extent to
eradicate tuberculosis.
Latterly I have noticed in Public Statutes relating to Public Health
matters that when obligations are laid upon sanitary authorities the word