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63
Government Board at a deputation of the Medical Officers of
Health, would be that legislation should require the householder to
give notice to the Sanitary authority of any case of infectious disease
occurring in the house under his control within twenty-four hours of
being informed of the same by the Medical Attendant. Of
necessity, the word householder would have to be accurately defined,
and the definition must be broad. Such a system would recognize,
first, that the Medical Attendant had a duty to his patient and to the
friends of the patient, viz. : to inform them of the nature of the
sickness; and, secondly, that the householder had a duty to the
Local Authority, viz.: to inform them of the report they had
received from their Medical man. I would even urge (so convinced
am I of the paramount importance of early information of even an
isolated case being in the hands of a Local Authority), that the
neglect on the part of the householder of giving such notice, should
be punishable by fine. The importance, however, of early removal
to a Hospital, so essential for the purpose of as far as possible
stamping out the disease, suggests another question. If the
patient is not a pauper, where are we to send him ? This difficulty,
it is right to add, has been rendered as far as possible during the
late epidemic, by the friendly action of the Metropolitan Asylums
Board, who without, it would seem, being by law compelled, have,
nevertheless (at any rate so far as Islington is concerned), refused
no patients sent them by the order of the Sanitary authority.
Nevertheless, on their part, we are informed it is an act of grace;
and we may fairly ask, without the slightest want of good feeling on
our part, that the act of grace should be made an act of right. The
fact is, it is harder to deal with non-paupers than with paupers, and
it is pre-eminently undesirable to make people paupers. Nor do I
for a moment see the necessary connection between pauperism and
Hospitals for infectious diseases, regarded in the light of a sanitary
provision for the advantage of the general population. Such
Hospitals are urgently required and might very fairly be placed
under the management of a Central Board, although at the disposal
of the Sanitary authorities; the former in no way interfering with
the authority of the latter. I should wish not to be misunderstood
in this matter. These Hospitals cannot be self-supporting. Of