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79
pulsory, and that it would devolve upon the officers of the Local
Authority to obtain such further information as might be requisite
in regard to the particular case. The Board therefore, declined
to alter their Order prescribing the form of the certificate,
but said that there could "be no objection to any medical
practitioner furnishing such additional information as the
Managers desired, if he were willing to do so. In the form of
certificate in use in this Parish, I had made provision from the
first, for obtaining the desired information, including age and sex
of the patient, and address of the certifying practitioner, and such
information has always been given. The Board now recognise
the imperfection of the statutory form of certificate, and in
the Public Health (London) Bill are now seeking power to
remedy the defects.* In the same measure it is proposed to
remove any doubt as to the liability of the Medical Officers of
General Hospitals to notify infectious cases, and should the Bill
pass a serious blot will be removed from the Act of 1889.
For a long time prior to the passing of the Act the Managers
had sent to the Medical Officer of each district, a daily return of the
cases for whose admission to hospital application had been made,
a return which was often the first, and sometimes the only, intimation
we had of the occurrence of infectious disease in
particular houses. When the weekly return of cases notified was
issued, the Managers decided to discontinue the daily return of
cases admitted to their hospitals. This proved a serious loss,
especially in view of the opinion expressed by the Local Government
Board, that it is not necessary under the Act for the
Medical Officer of a hospital to notify. The expression of that
opinion was attended with one good result, inasmuch as it led the
Managers, upon my application, to renew the issue of the daily
return of admissions to their hospitals, from which, even down to
the present time, information is obtained occasionally of cases
which medical practitioners have neglected or forgotten to notify.
* Vide page 90.