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29
We would remind the Committee of our report submitted to and adopted
by the Council on the 2nd August, 1905, in which we reported that we
recognised that the ultimate ideal should be
(a) That pulmonary phthisis should be notifiable, and
(b) That patients should be segregated for treatment, and
(c) That after death or removal the rooms of phthisical patients should be
disinfected.
We stated, however, that it was futile to deal with this matter by means
of mere voluntary action.
As an immediate expedient we advised the issue of pamphlets containing
instructions to patients and friends for distribution in the Borough, and these
pamphlets have been widely distributed, and such distribution is being
continued. It has for some time past been the Committee's practice to
disinfect rooms occupied by phthisical persons after death or removal, when
permission is granted for this purpose.
Upon the subject of voluntary notification we are still unable to see our
way to recommend the Council to adopt such a course, as we do not think from
the result of enquiries we made last year as to the working of this system in
other districts, that the expenditure involved would be justified by the results
which would accrue. Advanced cases are found to be notified again and
again by different medical practitioners, whereas the early and probably curable
cases are seldom notified unless the consent of the patient is given, and this is
often withheld. Many of the following reasons which we urge against the
compulsory notification of phthisis are equally applicable to voluntary
notification.
With regard to the suggestion of making phthisis a notifiable disease
under the Public Health (London) Act, 1891, we are of opinion that the time
is by no means ripe for this to be done. Notification is, we think useless, unless
followed up in a practical manner by isolation and disinfection. We do not
think that under the present circumstances the ratepayers should be called
upon to find the enormous funds which would be necessary to provide institutions
for the reception of phthisical patients of the poorer classes who are
in the early stages of the disease, and we think that such cases must be left to
the present voluntary hospitals and sanatoria. Again such patients are often
able to support themselves and persons dependent upon them by their own
earnings and it does not appear to us to be hygienically necessary or