Observations of the Medical Officer of Health [E.W. Hope] upon the report of Dr. R.J. Reece to the Local Government Board on smallpox and smallpox hospitals at Liverpool, 1902-3.

  • Hope, E. W. (Edward William), 1855-1950.
Date:
1905
Catalogue details

Licence: In copyright

Credit: Observations of the Medical Officer of Health [E.W. Hope] upon the report of Dr. R.J. Reece to the Local Government Board on smallpox and smallpox hospitals at Liverpool, 1902-3. Source: Wellcome Collection.

Provider: This material has been provided by Royal College of Physicians, London. The original may be consulted at Royal College of Physicians, London.

    7/48 (page 5)
    2-HOSPITAL ADMINISTRATION. With regal'd to the internal adininisti'ation of the hospitals, some important observations are made by Dr. Ueece. He criticise.s the methods in which the hospital registers and books have been kept, and suggests that it may be accounted for by the Resident Medical Olficeis liaving had no ja-evions experience of such work, and that their stay in the hos])ital is usually brief. Pie lays emphasis upon the consequence of the failure from time to time of the Resident Medical Officers of the hosjiitals to notify the Medical Oflicer of Health of cases received into the institution in othei' than the ordinary channel, viz., by the iVmbulance Department of the Medical Officer of Health, ami also of their failure from time to time to notify modifications of diagnosis, omissions, however, which it is only just to the Kesidents to say are relatively rare. Pie quotes, as an instance, a woman who carried her child to the hospital, and alludes to a number of other cases. It may be pointed out, however, that this trouble is of old standing. Indeed, as far back as the 18tli October, 1894, upon the recommendation of the Medical Officer of Health, this matter was the subject of a specific instruction of tlie Pffirt Sanitary and Hosjiitals Committee in the following termsThat it be an instruction to the Resident Medical Officers to the City Hospitals to furnish the Medical Officer of Health with the names, addresses, and mode of conveyance of jiatients admitted into the Hospitals otherwise than by the direction of the Medical Officer of Health, and also as to any patients admitted to the hospitals found to be suffering from a disease other than that specified ujion the certificate of admission, such information to be supplied in wiiting as soon as possible.” Those instructions, printed and framed, hang in the room of every Resident Medical Officer at each of the City Hospitals, but the Committee may be disposed to deal more seriously with any recurrence of a disregard of their orders in this direction. Dr. Reece says; “In this Report the City Hospitals receiving- smallpox cases are alone dealt with; but it is manifest that the scheme of supervision of the whole of the City Plospitals merits the attention of the Hospitals Committee of the Corporation.” This observation, suggesting negligence on the part of the Hospitals Committee of the Corporation is too general in character to admit of comment. Dr. Reece does not appear to have visited these institutions, nor to have taken steps to acquaint himself with the method of their supervision. He also takes occasion to observe (jiage 6) that the Medical Officer of Health has no direct administrative control over the various City Hospitals. Here again the very full explanations given him of the relationships of the Medical Officer of Health with the Hospitals have not enabled him to grasp the actual position, nor the nature of the connection between the Medical Officer of Health’s Department and the Hospitals. No one with practical knowledge of the sanitary administration of cities would suggest that the Medical Officer of Health of any large City such as Liverpool, Glasgow, Manchester, Leeds, Birmingham, Sheffield, Nc., could possibly exercise direct administrative control, over the City Hospitals. In a smaller district the Medical Officer of Health can, and frequently has with great advantage, the direct administrative control of the Fever Hospitals; but it would be inqiracticable in the large cities.