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At times when the Boarding Medical Officer is fully occupied, e.g. when there is a medical
emergency or several ships to be visited urgently, or to avoid delay to a ship in exceptional
circumstances, it is possible to check with the ship direct and with the co-operation of H.M.
Customs arrange for "free pratique" to be granted immediately and without the ship being boarded
by the Medical Officer.
3. Notifications Otherwise Than By Radio (Regulation 14(1)(b)
In the event of a ship not being fitted with radio, display of the visual signals as set out in
the Directions and Requirements would result in the appropriate action being taken.
4. Mooring Stations (Regulations 22 to 30)
On arrival of an infected or suspected ship, or any other ship on which there has been during
its current voyage and within the last four weeks before arrival, a case of disease subject to the
International Health Regulations (cholera, including cholera due to the El Tor vibrio, plague,
small pox, including variola minor (alastrim) and yellow fever), the medical officer may direct that
the master take the ship to a "mooring station" so that the ship does not come into contact with
other ships or the shore.
It has been agreed with the Port of London Authority and the Waterguard Superintendent of
Her Majesty's Customs and Excise that the Mooring Stations will be at suitable berths to be
allocated by the Harbour Master as required.
5. Arrangements For—
(a) Hospital accommodation for infectious diseases (other than Smallpox — see Section VII)
Since Denton Hospital has been taken over by the South East Metropolitan Regional Hospital
Board under the National Health Service Act, the Port Health Authority has continued to exercise,
through the Senior Assistant Port Medical Officer, and the Assistant Port Medical Officers, the
medical supervision of cases admitted to the hospital. The Nursing and administrative control
lies with the Dartford Group Hospital Management Committee. Consultant advice is available
through the Physician-Superintendent of Joyce Green Hospital, Dartford.
Cases which are likely to require specialised treatment or laboratory investigation are sent
direct, or via Denton Hospital, to Joyce Green Hospital or one of the larger hospitals in the
Metropolis.
If at all possible, cases of sickness are disembarked into one of the Port Health Authority's
launches for conveyance to Denton Hospital, there to be admitted or else put into a waiting
ambulance. Ships which are berthing at Tilbury Landing Stage can conveniently land sick cases
there, either into a Port Health launch or into an ambulance.
Should weather or other conditions make it inadvisable to land a case at Gravesend, the
patient may be allowed by the Boarding Medical Officer to proceed up River in the ship to the
dock, in which event arrangements are made with the Emergency Bed Service for the case to be
removed by ambulance to a suitable hospital immediately the ship berths.
(b) Surveillance and follow up of contracts
In the event of a vessel arriving on which there has been a case of a major infectious disease,
all persons on board are considered to be possible contacts.
Each contact is interrogated and asked to give full details as to name and the proposed
address in the United Kingdom to which he is proceeding immediately on disembarkation. If
necessary these particulars, together with an appropriate note of the circumstances, are then
forwarded to the Medical Officer of Health of the district in which the address of the contact is
situated.
The details obtained by direct verbal contact are written on carbonised paper so that one
copy can be forwarded to the Medical Officer of Health of the area to which the passenger/crew
member is proceeding and one copy retained for reference. Additionally, the contact is given a
reply paid card(s) so that he can notify the authority of any change of address during the surveillance
period. Each change is notified to the appropriate local authority.
(c) Cleansing and disinfection of ships, persons, clothing and other articles
Disinfection of infected quarters is usually arranged by the Port Health Inspector in whose
area the vessel berths. If, however, the space requiring disinfection is large, a private firm is
employed to carry out the disinfection under the supervision of the Port Health Inspector.
By arrangement with the South East Metropolitan Regional Hospital Board and the Dartford
Hospital Management Committee, the Disinfection Station at Denton Hospital is made available to
the Port Health Authority for the disinfection of clothing, bedding, etc., and, if necessary, for
the cleansing of persons.
Arrangements have also been made for infected bedding from ships in the docks of the London
Area to be sent to the disinfection station at Plaistow Hospital.
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