The Dominion FRIDAY, JUNE 20, 1919. THE EPIDEMIC REPORT

Dominion, Volume 12, Issue 228, 20 June 1919, Page 6

The Dominion FRIDAY, JUNE 20, 1919. THE EPIDEMIC REPORT

The Royal Commission on the Influenza Epidemic has clone some useful work. Sections of it's report, no doubt, will provide a groundwork for reforms making for the better safeguarding of tho public health. One of the most conspicuous features of thodocument, however, is a far more sweeping condemnation of the Public Health Department than is warranted by the evidence on which the Commission .based its conclusions. The severity of its strictures on the Department is distinctly out of accord with its ostensible rejection of the idea that in the course of its inquiry the Department was on trial. Whether it tried the Department or not, the Commission certainly has condemned it, and • that in no uncertain fashion. Few of those who have followed the evidence will fail to realise, however, that the facts adduced to a great extent relieve the Health Department of the odium the Commission seeks to fasten upon it. It is, of course, agreed that' there was a general failure to 'anticipate the epidemic, and that the country was ill-prepared to cope with its onset. But in estimating the responsibility of the Health Department for .this state of affairs it is only just to remqmbcr that since last October a vast amount of enlightening experience has been bought at a dear price, and also that for a very }ong time past thp Department has been starved, neglected, and under-manned without any effectual public protest being raised. One of the principal Departmental witnesses at the inquiry laid strong emphasis upon the fact that all the officers of the Health Department were engaged at high pressure in defined activities, and that it had no staff of professional men free to keep vigilant watch-upon events abroad and devise measures to prevent the introduction of dangerous infection. It is necessary to look well beyond the Department in assigning responsibility for the policy of false economy which led to its being in some respects weak and ill-organised when the epidemic broke out Bearing that fact in mind, it is difficult to recall any justification for the observation of the Commission:

AVe find that the hospital boards and much of the country appear to have been more awake than the Department itself. The presumably unconscious bias shown by the Commission against the Health Department to a serious extent vitiates its conclusions in. regard to the circumstances in which the epidemic arose. It finds in reference to the Niagara that while tho j matter is not one capable of absolute demonstration, there is a very strong presumption that the arrival of this ship was a substantial factor m the introduction of the epidemic. The facts in sight seem rather to prompt an opposite conclusion. The Commission falls into an extraordinary blunder regarding the date of the Niagara's arrival. One passage in its report states that:

The explosive outbreak of, tlie epidemic influenza seems to have begun at a time which would practically synchronise will the admission of the Niagara patients, 28 on October 12, 0 on October 18, etc. ■ The Niagara arrived actually on October' 13. It is thus perfectly clear that the epidemic was definitely under way before the ship entered Auckland Harbour. There is a distinct possibility that the landing of the Niagaras, patients intensified the virulence of the disease, but the question the Health Department had to decide was whether or not to quarantine a ship on account of a malady cases of which, in a form at least as serious, were already numerous ashore. Medical evidence goes to show that the type of influenza said to have been brought by the Niagara was no more virulent than that which had alreacly broken out in some parts of the Dominion, two months before the arrival of fcho Niagara. On the whole, therefore, the conclusions of the Commission in regard to this ship seem to lack justification. The precise circumstances in which the epidemic arose are still a'matter of conjecture even with the experts whoare best qualified to form an opinion on the subject, but meantime there is much to suggest that in its earlier stages it doveloped almost imperceptibly,

possibly as the .result of-repeated infection from overseas. Obviously, in order to Listen full responsibility on the Health Department, it would he necessary to show not only how the epidemic developed, but in what manner the onset could have been foreseen and averted.

The Commission gives well-merited praise to hospital hoards and other local_ bodies for what they did' in fighting the epidemic, but pays the Health Department much le«s than its due meed of credit in this connection. The facts are so fresh in memory thai they hardly need recounting. It will undoubtedly be tho general verdict that'while the local bodies did good work, and were splendidly assisted by volunteer organisations, tho Minister of Public Health and his Department gave the country a highly creditablo lead and one which was indispensable to the degree of success attained. Some disputes have arisen about detail payments, but this should not be allowed to obscure the fact that the Health Department took a part worthy- of its responsibilities in the. campaign which stamped out the epidemic. The Government, as Mr. Russelt, has pointed out, bore the entire cost of the emergency hospitals, and disbursed large sums also in paying for medical and nursing services, food, and other things. While complaining that the Department as a, whole lacked the foresight which should have impelled it to initiate general organisation in October, the Commission observes that "all officers worked unceasingly when tho trouble became acute." * This .is a somewhat inadequate recognition of tho devoted service rendered by the officers of the Health Department in the troubled days of the epidemic. . While it contains a great deal that invites criticism, the report, as was said at the outset, is not lacking in constructive suggestion. In the main the proposals it submits for the reorganisation and enlargement of the Health Department follow the evidence submitted by the Minister. After, the experience of the epidemic and with the possibility in sight that other invasions of the kind may have to be faced, Parliament and the country presumably are prepared to' incur cheerfully whatever outlay may be involved in reorganising the Public Health Department on such lines as wiU_ make for the greatest possible efficiency. At the same time the report gives due prominence to the fact that considerations of public health bulk large in the case that is made out for a sweeping improvement in housing and sanitation, particularly in the more congested centres of population. Such passages as the following ought to be set up_ as public notices in the towns and citiss to which they apply until improvement has progressed so far that they are no longer true:

Whilst the borough councils' appear to give very full attention to the gcnoral "■aintary requirements, there is no doubt that in all centres groups of houses, and in somo places nearly whole streets, stand as a constant mennco to public health, in that the houses are quite unsuitable for habitation with proper regard to iho health, particularly of tho women and children.

In regard to eliminating such conditions there is an imperative call for _ action and initiative bv local bodies, as well as by tho Government, and the action ought to be prompt and comprehensive. Boldlyplanned housing schemes and an increasingly stringent enforcement of sanitary regulations by a Health Department adequately organised and equipped are tho essential demands of the situation. It is eminently true, as the Commission contends, that "the general health of our people is undoubtedly the Dominion's greatest asset," and that the added efficiency of a completely healthy people would much more than balance the outlay involved in creating conditions consistent with health.