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There can be no doubt that when a ship has a case of smallpox, the earlier the port medical
officer gets aboard the more probable the success of his control measures. So much so, that when
a ship bound for London gives early notification of suspected smallpox it is the practice for the
London control team to board the ship off Brixham in Devon. Failing this the ship is boarded
as near to the entrance to the port as possible. To allow a ship with a declared case of infectious
disease, that might be smallpox, to proceed into the heart of London would be taking an
unjustifiable risk with the public health.
Doctors cannot be entirely replaced by other staff for, smallpox apart, there are occasions
when a port medical officer must go to a ship. The Public Health (Ships) Regulations, 19521961,
state "The medical officer may, and if so requested by the master or required by the
Minister shall, examine any person on board a ship on arrival or already in the district, when
there are reasonable grounds for suspecting that the person is suffering from an infectious
disease or has been exposed to infection."
In relation to outward bound ships the same principle applies, but here a time limit of three
hours is specified.
To meet only the basic responsibilities mentioned it is necessary, in London, to have a
launch capable of going to any part of the seaport at any time. It is also necessary to have, in
a port as busy as the Port of London, at least one medical officer available at all times. Consideration
of tide, the extent of the port and co-operation with Her Majesty's Customs, mean that
for his availability to be effective the medical officer has to be on duty with the launch at
Gravesend. Here is the inner "gateway" to the port —the point which all ships, except tankers,
entering the port have to pass, and where the pilot is changed and the Customs issue pratique.
That a doctor is the first representative of the port health authority to board an incoming
ship has many advantages. Not the least of these is the establishment of mutual confidence, so
that the master will always declare his cases in the knowledge that he will get a prompt decision,
balanced by experience and precedent to take into consideration the needs of the public health,
the patient and the ship.
In addition to the boarding of incoming ships in the control of infectious disease, the medical
officer on duty attends to the medical needs of patients in the port isolation hospital, and assists
with the medical inspection of immigrants.
With the staff and equipment ever present it is only natural that other services develop.
Perhaps the most appreciated of these is in connection with accidents and emergencies,either
arising in Gravesend Reach or in ships coming to that reach on passage in or out of the port.
With all these activities there inevitably occasions when calls coincide, but we have no hesitation
in giving absolute priority to infectious disease.
DENTON HOSPITAL
Although Denton Hospital nas Deen taken over oy the South East Metropolitan Regional Hospital
Board under the National Health Services Act, the Port Health Authority continues to exercise,
through the Senior and Assistant Port Medical Officers, the medical supervision of cases
admitted to the hospital. The nursing and administrative control lies with the Dartford Hospital
Management Committee.
Consultant advice on difficult cases is available through the Physician-Superintendent of
Joyce Green Hospital, Dartford, who whenever necessary transfers cases there for special investigation
and treatment.
The number of cases admitted to Denton Hospital in 1962 was as follows:—
Chickenpox 13
Dysentery 1
Gastro Enteritis Pneumonia 1
Herpes Zoster 1
Malaria 3
Measles 9
Measles Contacts 2
Miscellaneous 4
Mumps 2
Primary Vaccination 1
Pneumonia 2
Rubella 1
Salmonella Infection 3
Smallpox 1
Smallpox contacts 3
Paratyphoid 1
Whooping Cough 1
49
Unsuccessful vaccination 47
96
13