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46
During the past fifty years there has been a marked decline in the
mortality from tuberculosis in England due to the active administration
of district sanitary authorities and their officers, whereby overcrowding
has been diminished and the hygiene of the dwelling-house vastly
improved, and great advances made in the construction of houses,
improved drainage, better roads, purer water and milk supply, etc.,
etc. In the future, as in the past, the further diminution of deaths
from tuberculosis will depend on the thoroughness and efficiency with
which District Authorities carry out their duties under Acts of Parliament
other than the National Insurance Act. It is the Council of the
District—not that of the County—which possesses most of the statutory
powers to deal with the bad conditions which may be around the house
or place of work of the individual. It was with a full knowledge of
these facts that the Society of Medical Officers of Health in a memorandum
published on April 12th, 1912, stated their definite opinion that the
district Medical Officer of Health, to whom all cases of tubercle are now
notified, should be the executive head of the administrative system for
controlling the spread of this " white man's plague," both amongst
insured and non-insured persons.
The County of Middlesex accepted from the County Insurance
Committee the onerous task of finding institutional accommodation, as
the latter is forbidden by law to do so itself; so during the year the
County Public Health Committee, under the Chairmanship of Mr.
Kelland, has had a busy time. Fortunately, in August, beds were placed
at their disposal for sanitorium treatment of insured persons at the
Middlesex Districts' Joint Hospital at South Mimms, of which Board
Edmonton is one of the sixteen constituent authorities, but it has not
yet been found possible to secure special hospitals for advanced cases, who
go, as before the Act was passed, to the out-patient or in-patient
departments of the old-established general or special hospitals, or into
Poor Law Infirmaries. One, of course, recognises that some time mustbe
allowed to elapse before "sanitorium benefits" in their fullest definition
can be open to all who require it, or think they require it.
From the Local Government Board we received a circular letter,
dated 14th May, entitled "Parliamentary grant for sanitorium purposes.
Finance Act, 1911, and National Insurance Act, 1911," also a. copy of
the Interim Report of the Departmental Committee on Tuberculosis (no
date). The consideration of these documents was deferred until the
County Council had formulated their scheme.
On June 28th I received the report of the 27th of that month from
the County Public Health Committee which contained a " Scheme for
dealing with Tuberculosis in the County of Middlesex." A report
thereon was presented on July 9th to my Council by Councillor Preb.
Sanders and the Medical Officer of Health. The scheme proposed the