View report page

81
prevention is by far the most important, and everything else should
be subordinated to secure the efficiency of the Tuberculosis Service
as a preventive service.
In London this is done by linking up prevention and detection,
giving to the Medical Officers of Health full comprehensive knowledge
of the whole of the problem so far as it affects their area.
Outside London, unfortunately, except in the case of County
Boroughs, this happy state does not obtain. Detection is linked
up with treatment.
In the past there has been something to be said for this. The
prevention of tuberculosis has never been so seriously entertained
generally throughout the country as it should have been. Nor
has there been in the past evidence that any activity by a Local
Authority which had for its object the prevention of tuberculosis
would obtain such a measure of public support as to make it
efficient.
On this account it has been in a measure wise to link up detection
with treatment, so as to increase the efficiency of treatment,
in the hope of indirectly helping prevention ; but the people of
England are becoming more interested than ever in the prevention
of tuberculosis, and particularly have I noticed this in Barking.
Where Local Authorities have such an intelligent and enlightened
public opinion behind them it is obvious that everything
should be done, as I have said, to increase the efficiency of direct
prevention, and the benefit of combining prevention and detection
outweighs any minor advantage of combining detection and
treatment.
It is only when a Medical Officer has—as the Medical Officers
of the Metropolitan Areas have—a comprehensive knowledge of
the whole of the problem that this prevention can be really efficient.
It is to be hoped that in the future, where Athorities responsible
for prevention are able to undertake the responsibility of
detection, this responsibility shall be conferred upon them.