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106
rightly notifies the disease to the Medical Officer of Health of the new
district. If that notification appears in the returns to the RegistrarGeneral,
his figures of notifications give a false indication of the number
of new cases learned of during the year. Yet another complication
occurs more especially in those districts near London because of the
varying procedures to be followed in regard to diseases diagnosed al
hospitals, some of them being classed to the districts from which the
patients were admitted, others being classed to the districts in London in
which the hospitals are situated. Although, then, the practice of
notification is governed by Section 144 of the Public Health Act, which
reads: "When an inmate of any building used for human habitation
not being a hospital in which persons suffering from an infectious disease
are received is suffering from a notifiable disease . . . every medical
practitioner attending on or called in to visit the patient shall, as soon as
he becomes aware that the patient is suffering from a notifiable disease
send to the Medical Officer of Health of the district in which the building
is situate a certificate stating the name of the patient, the situation of the
building and the disease from which in the opinion of that medical
practitioner the patient is suffering," to prevent the inclusion of the
same case in the returns from more than one district a circular from the
Registrar-General's Office G.R.O. Circular (M.O.H.) No. 1/1955 sets out
the following requirements:—
(1) Subject to the exceptions set out in the following sub-paragraphs,
notifications are required to be made to the Medical Officer of
Health of the district where the patient is when the notifiable
disease is diagnosed. The notification should be counted in the
return for that district whether or not the patient is normally
resident there. Particulars passed for information to the
Medical Officer of Health of the district of normal residence
should not be counted as notifications in the receiving district.
(2) Tuberculosis notifications are required to be made to the Medical
Officer of Health of the district in which the patient " is living
at the time." In general, this will be the district in which the
patient is normally resident. The regulations provide that if
the patient normally resides in a place other than that in which
he is living when the disease is diagnosed, full particulars must
be passed to the Medical Officer of Health for the former area
The notification should, however, be counted for the purposes
of weekly and quarterly returns only in the area where the
patient " is living at the time." Notifications " transferred
from one area to another on removal of the patient's normal
residence should not be counted in the weekly and quarterly
returns; the returns relate only to new cases notified. In M
case of patients where the disease is diagnosed in hospital,
notifications will usually be sent to the Medical Officer of Healtn
of the area in which the patient normally lives. In the case of
certain long-stay patients (such as many patients in mental
hospitals) the hospital will be regarded as the patient's residence,
and the notification should be sent to the Medical Officer of
Health for the area in which the hospital is situated.