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Home
nursing and
hospital
accommodation.
The medical officers of health of the metropolitan boroughs are generally in agreement
as to the usefulness of the scheme, and there is no doubt that the procedure
has been of value in enabling them to secure knowledge of cases of measles and so
assisting them in rendering any necessary assistance to the parents, either by way
of home nursing or by removal of the cases to hospital.
The metropolitan boroughs are empowered under the Maternity and Child
Welfare Act, 1918, to provide nursing and medical assistance in the case of children
under five years of age suffering from measles and certain other diseases dangerous to
young life. They are also empowered to deal similarly with adults under Section 77
of the Public Health (London) Act, 1891. Medical officers of health receive information
of the occurrence of measles from various sources, viz., the school organisation,
infant welfare centres, health visitors and other health officers during the normal
course of domiciliary visits, and in 10 boroughs by statutory notifications under local
orders making measles a compulsorily notifiable disease. Compulsory notification
on a larger scale has frequently been tried, but has as often been abandoned. There
is considerable difference of opinion as to the value of such a measure as applied to
measles, but the protagonists of the system contend that one of its chief advantages
lies in the fact that, where a disease is compulsorily notifiable, it is regarded with
greater seriousness by the parents, and is, therefore, valuable from an educational
and propagandist point of view. The general view is, however, that sufficient means
are available, through the school organisation and otherwise, for ascertaining the
existence of cases, and that if all possible steps are taken to speed up the machinery,
there is no need to supplement these sources of knowledge by statutory notification.
As soon as a case of measles is reported to a medical officer of health, the health
visitor makes domiciliary inquiries, and if nursing assistance is required in the home,
a local nursing association, with whom the borough councils have working arrangements,
sends a nurse to the home, or, if the home conditions are unsatisfactory and
unsuitable for proper nursing, the case is removed to hospital if there is sufficient
accommodation. Arrangements with district nursing associations to provide
treatment in the homes are in operation throughout the London boroughs, although
these facilities were more freely used in some boroughs than in others, possibly
because in the latter there had been little demand owing to the mildness of the
disease, or from other causes. In future epidemics much greater scope in the matter
of hospital accommodation will be provided as, arising out of an informal conference
at the Metropolitan Asylums Board, consisting of representatives of the Board, the
Ministry of Health, L.C.C., and the Metropolitan Branch of the Incorporated Society
of Medical Officers of Health, on 20th April,1926, it was agreed that it would be