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in hospitals. This applies more particularly to the elderly, chronics,
some of whom have to remain at home in very difficult circumstances
and at great hardship to those looking after them, because of an inability
to arrange their admission to hospital. The elderly and infirm, as such,
though not suffering from any added ailment which renders medical
or nursing attention necessary, form another group for whom more
adequate provision is necessary. Section 47 of the National Assistance
Act gives powers to the medical officer of health to arrange for the
removal, to suitable premises, of persons in need of care and attention.
The powers of this section though should be invoked more particularly
where it is necessary that the person should be removed either in his
own interests, or perhaps more often, in the interests of others. The
section does not provide any additional accommodation for those many
who would be only too willing to take advantage of suitable provision
if it were available. The transference of the isolation hospitals from
the local authorities to Regional Hospital Boards has resulted in the
medical officer of health (except where he continues to be associated with
the hospital) being less closely alive to the problems of the infections in
his district, and has resulted perhaps, in the medical practitioners being
more casual in sending in their notifications. In this district, the
buildings previously used for the reception of those suffering from
infectious diseases have been put to other purposes. This is a change
which would have come about even though the National Health Service
Act had not been passed. In the light of their experience since 1934,
as to the needs for the district of isolation accommodation, the Council
had decided that 100 beds would be sufficient, and had approached the
Borough of Hendon to see if the Hendon Isolation Hospital could not be
extended to cater for those to be admitted from Harrow. In many
other parts of the country, it seems that the smaller isolation hospitals
are now being closed. It is to be hoped that, whatever is being done on
these lines, is being carried out with a full appreciation of the reason for
the practice of former years. To-day, scarlet fever is a mild disease;
even in the years when it becomes prevalent, there are not many cases
needing, on clinical grounds, to be admitted to hospital. In most
districts the practice had been adopted of admitting to the isolation
hospital those suffering from the complications of measles and of whooping
cough. Both these diseases too, are very much milder clinically than
they were some years ago. Why this change should have taken place
in these three diseases almost concurrently, is not known. It would
be gratifying to feel that it is because of some improvement in the state of
the human hosts, something which is the result of some improvement in
the national way of living, such as improved feeding. But there is little
assurance that this is the explanation, and there must always be the risk
of these organisms reverting to a more serious type. Not so many years
ago, a type of the organism of diphtheria caused a variety of the disease
which did not respond to the serum which was quite effective in treating
the illness caused by other strains. If the haemolytic streptococcus
sported a variant of that nature which resulted in a severe clinical variety
of scarlet fever, would there be sufficient isolation hospital accommodation,
and would those in charge of the hospitals be so anxious to have patients