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receipt of urgent representations from various public authorities,
the Managers, “ convinced of the hopelessness of coping with the
disease by any other means, countenanced the practice of removing
cases upon the application of the officials of Nuisance Authorities ”
—under circumstances very fully set out in my Annual Report for
that year—“ a step the wisdom of which has never been
challenged.” The Managers are now prepared to go a great deal
further. For very sufficient reasons they decline to admit a
patient to the Ambulance without the production of a medical
certificate, but they are "by no means satisfied that any useful
purpose is now served by the intervention of the
Relieving Officer as an admitting, or rather removing, authority,
while" (as I pointed out in the above-mentioned report) " .
the necessity of obtaining his order prior to removal, if insisted
on in every case, would prevent some cases from being removed at
all, and in many others must interpose a delay prejudicial to the
patient, distressing to his friends, and dangerous to the health of
the locality." The Managers now recognise the fact that " delay
means largely increased expense to the Ambulance Service," while
" the performance of a formal and unnecessary function entails
waste of valuable time on the Relieving Officer." And having regard
to the fact that " it has in practice been found impossible for
the Managers to distinguish between ‘ pauper ’ and ‘ non-pauper ’
patients," and to the benefits to be derived from the early isolation
of cases of infectious disease, the Managers, as already stated,
have unanimously resolved to "apply to the Local Government
Board for, or to obtain, authority to remove all persons suffering
from fever or small-pox whose removal shall be applied for by duly
qualified (registered) medical practitioners ; the practice of at once
communicating the removal of every patient to the Clerks of
Guardians being of course continued."
This decision will afford the greatest satisfaction to all
concerned in sanitary administration. To myself it is peculiarly
gratifying that views which, when I first published them, were
deemed extreme, have now been so fully accepted by the
Board. But it is no great matter for surprise, the Managers