HH62/1/FIFE/15

Transcription

[page] 14

insanitary condition of whole villages have been dealt with, individual
houses must certainly be examined. From my general inspection of
the Districts, I am able to state that, to fulfil my duty under the Hous
ing of the Working Classes Act, there is work in store for several years.

INFECTIOUS DISEASES (NOTIFICATION) ACT 1889.
This Act has been adopted in all the Districts of Fife. It is
desirable that there should be a clear perception of the provisions and
objects of the Act, as they are not generally understood. By the adop-
tion of the Act, its is imperative that every medical practitioner attend-
ing, or called on to visit, a patient suffering from an infectious disease
to which this Act applies, will send to the Medical Officer of Health to the
District a certificate stating the name of the patient, the situation of the
building, and the infectious disease from which, in the opinion of the medi-
cal practitioner, the patient is suffering. It is also imperative that the head
of the family, and, in his default, the nearest relatives of the patient
present in the house, the person in charge of, or in attendance on, the
patient, or the occupier of the building, shall also notify, in like manner,
as the medical attendant, Every person who fails to grant a certificate
is liable to a fine of two pounds. It will be seen that a system of
notification is dual, and, as well as a medical man's certificate, one must
be sent by some one of the persons above referred to. This duty up
to the present time has been neglected, and only medical certificates
have been forwarded to me. I am sorry also to state that in some
instances medical certificates have been sent in after considerable elapse
of time since the patients have been affected, but the Act being newly
introduced, and this duty therefore new, it may have thus been forgot-
ten. I must impress upon everyone concerned with the duty of notifi-
cation, of the importance of early intimation of cases.
The Act is not compulsory meantime; but, judging from recent
remarks of the President of Local Government Board, it will soon
be so; and this is highly desirable, as, unless the Act applies equally
to every part of counties, very much of the benefit of early inti-
mation of infectious cases in the places where the Act is in force will be
lost, from importation of infection and from those places where this very
important sanitary Act does not apply.
In the County of Fife there is only one burgh, as far as I know,
which has adopted the Act; and it would only be fair for all the burghs
to follow suit, and confer on rural districts a benefit similar to the one
that rural districts confer on burghs. Sanitary administration to be
effective must be uniform, not only in every part of a county, but in all
counties, and until this is possible by a new Public Health Act, appli-
cable to rural and urban districts alike, the struggles made against
disease by our vigilant Sanitary Authority will be defeated by the indif-
ference of others to all preventive measures, and which are so often
considered to be meddlesome, and the cost which they cause extrava-
gant, forgetting that no extravagance is so wasteful as that of human
lives.
Since the Notification Act was adopted, I was asked to report on
what other diseases, other than those mentioned in the Act, should be

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included as notifiable diseases; and to Cupar District Committee I
reported on the reasons for and against the notification of measles,
whooping-cough, and tuberculosis. As there is no isolation hospital
in this District, I could not recommend very strongly that any others
should be included until a hospital was provided, and until further
experience of the working of the Act as it is had been gained.
The following statistics of the mortality of measles, whooping-
cough and tuberculosis in Fife, and for the whole of Scotland for ten
years, show the necessity of preventive measures being attempted to
deal with these important diseases.

[table inserted]

These three infectious diseases increase the mortality of Fife to a
great extent, and whooping-cough and tuberculosis do not show much
tendency to decrease. Yet they are like other infectious diseases -
amenable to the influence of sanitary reform. The advantages of these
diseases being included in the Notification Act, would be from its being
then possible to instruct friends and relatives of patients how to
prevent others from being affected by adoption of preventive measures.
In the following table a statement of the cases of infectious
diseases, notified to the Health Department since 1st October is given:-
TABLE.
CASES OF INFECTIOUS DISEASE COMING UNDER THE NOTICE OF THE
HEALTH DEPARTMENT DURING THE YEAR 1891.

[table inserted)