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14
The whole question of vaccination and re-vaccination is one of prevention
of disease, and as such should clearly be in the hands of the Public Health
Department.
The prevention of disease in no way concerns the Poor Law Administration,
and its association therewith is not calculated to increase its importance or
popularity in the public mind. This was shown in the early days of the
Metropolitan Asylums Board, when it was found that the association with
Poor Law was a hindrance to many persons, and Parliamentary enactment
was found necessary to deal with the question.
Inasmuch as the spread of Small-pox is a matter for the Public Health
Department, and the prevalence of Small-pox is directly dependent upon the
amount of protection by vaccination, it seems only reasonable that such
Department should be able to control the system upon which they have to
rely.
By vaccination being placed in the hands of the Guardians, the Public
Health Department is deprived of by far the most important factor—one
may almost say the only one—in the case of prevention of Small-pox.
30 & 31 Vic.,
cap. 84,
sec. 28.
In the 1867 Act there is a Clause enacting that the Guardians may pay all
expenses in working this Act, and in or about'inquiries and reports as to the
state of Small-pox and Vaccination in their Union or Parish, and in taking
measures to prevent the spread of Small-pox. It is noteworthy that practically
no Board of Guardians has given any effect to the latter part of this Clause,
and it has remained with the Medical Officer of Health to carry out these
inquiries, more especially since the Notification Act came into force. When the
Vaccination Act was passed, the laws relating to public health were in their
infancy, and the 1875 Public Health Act, not to speak of the more extended
1891 Act, was not thought of.
It is, however, a fact worth noting that so long ago as 1868 Sir John
Simon, then Medical Officer to the Privy Council (the first Medical Officer of
Health to the City of London), in referring to the subject, says: "The
"authority for public vaccination is now universally the destitution-authority,
"which in all common health-areas is identical with the nuisance-authority,
"but in all special health-areas is separate from it. Under the system I am
"suggesting, public vaccination in the common health-areas would remain
"practically unchanged; it would be one of the health-functions of the
"double-functioned local authority; but as regards special health-areas, it
"would certainly admit of question whether public vaccination ought not
"rather to be a function of the consolidated health authority than a function
"of the authority for destitution; and I am myself disposed to think that
"in those areas the transfer would generally be desirable."