HH62/2/RENFRE/31

Transcription

[Page] 30

supererogation in England, where, as the result of ampler experience,
cela va sans dire.
I entered upon office in the middle of January, 1891, and from
that time, under the controlling hand of the County Council, the
Special Committee, and the District Committees, the county sanitary
organization evolved itself, slowly, step by step, so cautiously that it
was not until the end of the year that the County Health Depart-
ment would be considered fully organized. The first step was the
authorisation of the engagement of a clerk by the medical officer of
health. The next was the appointment, under the requirements of
the Local Government Act, of a 'county sanitary inspector or sani-
tary inspectors.' The County Council and the special Committee, in
consideration of the considerable size of each of the two Districts
into which the county was divided, decided to appoint two county
sanitary inspectors, each of whom should also be Chief Sanitary In-
spector for one of the Districts. There were about two hundred ap-
plications for these appointments, and the special Committee, after
the most careful consideration, from a select list prepared by myself,
appointed the two gentlemen who appeared most suitable. The next
question which arose was that of the retention, or otherwise, of the
parochial sanitary officers - to act under the control of the county
medical officer of health and sanitary inspectors. After full considera-
tion of all the circumstances of the case, I felt bound to advise that
the local officers should be relieved - most of them were most anxious
to be relieved - of their somewhat invidious duties, and that assistant
inspectors should be appointed, who should not be hampered by any
private engagements. The County Council and District Committees,
in consideration of the relatively small size and compactness of the
county, its advantages in respect of railway accommodation, and in
view of certain suggestions, subsequently to be developed, for the
further annihilation of distance, and having in regard the broad prin-
ciple that it is undesirable that public officials, and especially sanitary
officials, should be engaged in private work, determined to dispense
with the services of the local officers (who should be duly compen-
sated in accordance with the Civil Service system), and to appoint
two assistant sanitary inspectors for the First District, and one for
the Second, debarred from private work. The services of the local
officers were retained until the county officers should have obtained
a sufficient acquaintance with the sanitary history and the topography
of the county. To meet possible emergencies, which are likely very

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seldom to arise, I was authorised to have recourse, when required, to
the services of local medical men, to be paid by fee. Offices were
secured in an accessible position in the County Buildings for the
medical officer of health and the chief sanitary inspectors (who
meet here daily, from nine to ten A.M.), and arrangements were made
for connecting them with the trunk telephonic system of the district.
Office accommodation was obtained for the assistant inspectors at
Barrhead, Pollokshaws and Greenock, all in close association with the
connty police centres in these towns, so that morning (9 to 9.30 A.M.)
and afternoon (4.30 to 5 P.M.) daily telephonic communication should
be established between the head office and the assistant inspectors, so
that the sanitary circumstances of the whole county could be focussed
in the medical officer of health and chief sanitary inspectors without
any loss of time.
On the fifteenth of May the Infectious Disease (Notification)
Act was brought into operation all over the County. I venture
to believe that it will be regarded as a standing memorial to
the sagacity of the District Committees that this was done in each
case by a unanimous vote, and without requiring the least prompting
from me. Matters were in train at the end of the year for the inclu-
sion of Measles in the list of notifiable diseases.* I was in doubt, at
first, as to whether all notifications of cases of infectious disease should
be addressed directly to me, or whether the more remote ones should
be sent to me, care of the assistant sanitary inspectors. The essence
of the matter, in such cases, is promptitude of action. By the adop-
tion of the telephonic connection, however, the problem was simpli-
fied, and I was able to arrange that all notifications should be ad-
dressed to me, at the County Buildings, enclosed in blue envelopes
(with which all the medical men practising in the county were pro-
vided, along with their books of notification-forms), bearing a printed
address, so that a notification would be at once recognisable on re-
ceipt, and opened, in my absence, by the clerk or one of the chief in-
spectors, and dealt with as speedily as possible. In practice, most of
the notifications arrive by the morning's post, the particulars are at
once telephoned to the assistant inspectors, unless the cases are situ-
ated within home-districts of the chief sanitary inspectors; and the
first business of the day, for the inspectors, is to attend to such noti-
fications. Notifications coming in in the course of the day are tele-
phoned to the branch offices between 4.30 and 5 P.M., and if practi-

* Subsequently carried into effect in each District by a unanimous vote.