Volume 2

First-[second] report of the Royal Sanitary Commission.

  • Great Britain. Royal Sanitary Commission
Date:
1869-1874
Catalogue details

Licence: Public Domain Mark

Credit: First-[second] report of the Royal Sanitary Commission. Source: Wellcome Collection.

Provider: This material has been provided by London School of Hygiene & Tropical Medicine Library & Archives Service. The original may be consulted at London School of Hygiene & Tropical Medicine Library & Archives Service.

    206/418 (page 198)
    J. Hill, Esq., Poor Law Commissioners, contains a return of the M.D. number of cases of certain diseases that have occurred, and I think that that return might be extended, so 12 May 1870. embrace a few more of the more important zymotic diseases which would be likely to occur. We have returns of scarlatina, fever, and smallpox, and there is a space left on the return, where the medical officer is requested to state the number of cases of any other disease that may have been epidemic during the quarter ; and they very often say that they have had 20 or 30 cases of measles or 20 or 30 cases of whooping cough, or of any other disease that may have been prevalent. 12.235. With regard to the duty of chief inspectors, and the duty of the medical officers of dispensary districts, I should like to put this question to you. When you visit a district and meet the medical officer of the dispensary, do you expect him to report to you if there is anything in his district which requires remedy in his judgment ^—One of the questions that I always ask him is, What is the sanitary state of your district ? 12.236. Supposing there is a foul hamlet, which any time in the last hundred years Ought to have been put in order, does he report that to you in writing, or does he make an oral report when you see him?—He probably tells me I have had several cases of fever in my district in such a place, and I attribute it to the very foul state of some back lanes, and so on; and if he does that I most likely report it to the commissioners. 12.237. Then do the commissioners report it to the Castle ?—No. The commissioners would then inform the board of guardians (that is if it were in their jurisdiction) of what they had heard either from me or the medical officer or from whatever som'ce they had got it, calling their attention to it, and requiring them to take measures to have the nuisance abated, and then the board of guardians would du-ect their sanitary officer, that is to say, their relieving officer, for he is generally the relieving officer, to visit the place and take measures to have it cleansed and white- washed, or if it be a nuisance to serve a notice on the occupier or on the owner to have that nuisance abated within a certain time, and they direct their relieving officer to report that day fortnight, we wiU say, whether the nuisance has been removed. 12.238. What is the usual consequence of all that ? —In the rural districts the consequence generally is that the nuisance is abated. 12.239. That gives us a picture of a country per- fectly clean and prosperous ?—It is not at aU the case, I am sorry to say. 12.240. It must be clean, if all your directions were carried out ; quite a garden ?—Yes ; but our directions are not always carried out. We have no means of obliging people to do it. 12.241. {Mr. Powell.) Yon put it in this way, that the difficulty arises because the power which ought to compel the owners declines to compel the owners, and because those who ought to be compelled decUne to be compelled ?—Yes. 12.242. {Dr. Acland.) You have had large expe- rience in inspection, both as a medical officer and as a poor law inspector. What is your judgment of the size of a district which it would be reasonable to assign to a ffi:st-class inspector ; you had at one time, I think, one of the provinces of Ireland ?—I had 40 unions. 12.243. That was as a medical inspector ?—Yes. 12.244. Merely inspecting the dispensaries ?—Yes, merely inspecting the dispensaries. I have 12 unions now. 12.245. And now as poor law inspector you have to inspect the sanitary condition as well as the dis- pensaries ?—Yes, I have to inspect the workhouses and the dispensaries. The witne 12.246. Is that number of unions about what you would think a fair allowance ?—I have, I believe, the smallest disti-ict in Ireland, because, being resident near head-quarters, I conduct or assist in inquiries in respect of sanitary matters which would be held by the other inspectors. 12.247. There are 11 inspectors altogether, are there not ?—^Yes, there are 11 inspectors, the number of unions being 163. Some of the inspectors have 15 or 16 unions. 12.248. Do you find that medical men generally are willing to join in preventive sanitary inquiries, or do they dislike the work ?—I think that they take great interest in it; they have a direct interest in keeping their districts healthy. 12.249. You do not think that gentlemen engaged in the practice of their profession generaUy would be unwilling to give information on general sanitary matters ?—I think they would not be at aU imwilling, and in the course of their ordinary duties they Avould have ample opportunities of ascertaining the sanitary condition of their respective districts. 12.250. Do you think that it would tend to the im- provement of the members of the medical profession who were situated in remote districts, to keep them informed through your office of all that was going on in preventive science ?—I think it would. 12.251. And that would be the natural result of the close communication which you would have with all of them ?—Yes. We have, as I have mentioned, a quar- terly communication from every medical officer, and in addition to that, the Poor Law Commissioners have by means of circulars called upon the medical officers all through the country to report directly to them, the occurrence of any disease which is likely to be epidemic.. 12.252. That is du-ectly to your office?—Yes, directly and immediately, not through the guardians. ] 2,253. Do you transmit to them information and copies of your reports ?—^No. 12.254. Would it not be desirable that the central office should send them copies of scientific reports, or information which might be useful in the discharge of their public duties ?—Sometimes, when anything of importance does occur, such information is reduced to the form of a circular, and is distributed all over the country to boards of guardians, committees of management, and to medical officers of districts. 12.255. Do all of them receive copies of your poor law reports ?—No. 12.256. Do they receive copies of the Registrar Glenerars returns ?—I should think not. I am not quite sure about that. 12.257. Is it a reasonable thing that the Govern- ment medical officers, having responsible duties, should not receive regularly copies of Government papers of this kind ?—-Formerly every committee of management thi'oughout the country received two copies of the poor law reports, and boards of guardians still receive a certain number of them, but some years ago there was an order that the distribution of them to dispensary committees should be discontinued, I believe on account of the cost. 12.258. Was that an order from the Lord Lieu- tenant, or an order from the central Government ? — I do not recollect now, but it was a Government order that the distribution of those large numbers of reports should cease. 12.259. {Mr. Powell.) When you spoke of medi- cal officers acting as sanitary inspectors, did you mean that they should simply communicate to any proper authority any information which they might have received ?—Yes, I think that is the best use that could be made of them as sanitary inspectors. 12.260. Then they are not at aU bound to foUo^v up each individual case of nuisance by summoning the parties before the magistrates, &c. ?—No. 1 withdrew. Adjourned.