London's Pulse: Medical Officer of Health reports 1848-1972

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Finchley 1894

[Report of the Medical Officer of Health for Finchley]

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20
therefore notified, makes it probable that those children who are
susceptible to attack are already infected before one can receive
and act upon a notification; and this circumstancc partly
accounts for the fact that even School closure in epidemic times
is frequently inoperative. Notification, moreover, in addition to
proving expensive would have its utility further curtailed by
reason of the following facts Among the majority of the poorer
householders anything approaching efficient isolation would be
found to be impossible, and it is not practicable for any
community to provide sufficient hospital accommodation and
nursing for the scores of very young children (the large proportion
under 5 years of age) who, during epidemic prevalence,
would require such isolation ; and the best fruits from notification
could not therefore be reaped. Another argument, and one which
I consider the most potent against compulsory notification of
these two complaints, is that the poorer section of the community
regard the disease as more or less trivial, and on this account do
not consult a medical man—at least unless grave symptoms
supervene, and even in the latter case the little patients frequently
receive no better treatment than from the hands of a dispensing
chemist. Obviously these cases which, cropping up in houses
generally crowded with other children, are the most potent for
harm would not be notified and we should mainly receive and
pay for the notification of cases among the better class people
who have already called in a medical man and received the
benefit of his advice.
Then it has been suggested to enforce on the parents or
householder the notification of the malady. I believe this would
prove an utter failure in practice, and, even if a quid pro quo
were given for the information, most parents would carefully
balance the pecuniary advantages which they received against
the disadvantages and inconvenience which we might find it
our duty to put them to before they took action, and as a
consequence of this set off I believe they would count the balance
in favour of non-notification.
In short, my opinion is that no powers or resources at
present possessed by Local Authorities will suffice to secure that
large measure of control that is necessary to check the spread of