HH62/2/RENFRE/33

Transcription

[Page] 32

cable are still attended to that day. Having in recollection difficulties
which had arisen in connection with the working of the Notification
Act, in my past experience, I endeavoured to anticipate such by ac-
companying the issue of the formal intimations of the adoption of
the Act to medical men, by a friendly circular letter, in the course of
which I said:- 'I particularly desire that if at any time you should
think you have reason to complain of anything I have done or left
undone, you will let me know frankly and at once, in order that I
may have an opportunity of explaining or apologising.' I am glad to
say that on one or two occasions when difficulties, which might have
developed into unfriendliness, arose, matters were amicably settled by
mutual explanation. To meet cases of emergency which might arise
on Sundays or out of office hours, all the medical men in the county
have been furnished, in their notification-books, with my private ad-
dress and that of the Chief Sanitary Inspectors.
One difficulty arose in connection with the retirement of the
parochial sanitary inspectors, in that the less-informed section of the
community lost the media through whom they had been wont to
lodge complaints, or address communications to the sanitary authori-
ties. With the sanction of the Standing Joint Committee, and the
cordial co-operation of the Chief Constable for the County, arrange-
ments have been made by which every county constable has been in-
structed to receive complaints and communications for the County
Health Department, and to forward them forthwith to headquarters.
For that purpose constables have been provided with special memor-
andum forms and envelopes, and bills have been posted all over the
county making these facilities known to the public, which bills will
be renewed every year - on the village notice-boards which I hope to
be able to arrange for. The Chief Constable in the 'General Order'
issued to the force, giving instructions as above, was good enough to
add - 'They [all officers and constables] must also report anything of
an insanitary nature which comes under their observation, or any sus-
pected case of infectious disease which has not been reported to the
Public Health Department.' Members of the general public, instead
of having as formerly, only one official in a parish with whom to
lodge complaints, have now one in every village, and the Public
Health Department has received a large accession of strength through
the co-operation of the police force. I am not aware that in any
other county has an arrangement so conducive to efficiency been en-
tered into, and I feel personally indebted to the Chief Constable for
taking the matter up so readily and heartily.

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It is a great advantage to start with a clean slate. In formulating
a scheme of Office Registers and Forms, I have endeavoured to make
due use of this advantage, and for that purpose have drawn upon my
own experience of the past, and upon the forms used in other well-
conducted offices of the like character, in particular, upon the forms
in use in the City Health Department of New York, one of the best
organised Health Departments in the world, the working of which I
took occasion to study on the spot, a year or two ago. In order to
avoid confusion, the work of the two Districts having to be directed
from one office, I have arranged that, for the most part, the forms for
the First District shall be on white paper, those for the Second on
blue, and that the registers and books for each District shall have
distinctive bindings. For each District there is a Register of Cases
of Infectious Disease, having headings corresponding to those in the
inquiry-forms of the visiting inspectors; these are posted up daily,
and are found - as their well-thumbed condition indicates - of great
service. They are so arranged as to form a record of the amounts
due to medical men for notifications; and each medical man's account
is made up in the office half-yearly, initialled, and sent on to the
District Clerk, who, after the audit of the Finance Committee, for-
wards the accounts, with P.O., to the medical men. This arrange-
ment saves the medical men trouble, and materially simplifies the
work of the clerk as treasurer. The inspectors proceed to the inspec-
tion of a dairy-farm armed with a special 'inspection form,' with
headings based upon the Dairy Regulations, and dealing with every
detail in connection with a farm steading and its precincts. In the
office is kept a Register of Dairies for each District, the left-hand
pages of which are duplicates of the inspection-forms, and will con-
stitute, when filled in, a complete statement of the condition of every
farm-steading in the County as when taken over by the County
Council; the vis-à-vis pages are plain-ruled, and will constitute a
record of future inspections and of any alterations in the condition of
the dairies. Each inspector is furnished, in addition to his diary,
with a Monthly Abstract-sheet of work done, ruled vertically for the
days of the month, and having at the side a printed detail of every
possible incident of work. It is thus possible to see at a glance the
amount and variety of work done by each inspector during the
month, and on any given day. The printed minutes of the County
Council and District Committees are preserved in copiously-indexed
files, for purposes of reference: it would otherwise be impossible to