MEDICAL HEALTH OFFICERS.

Manawatu Herald, Volume XLI, Issue 2055, 15 November 1919, Page 4

MEDICAL HEALTH OFFICERS.

OPPOSED BY THE DEPARTMENT. ANOTHER INPSECTOR TO BE APPOINTED. AI Thursday's meeting of; the Palmerston North. District Hospital Board a letter was received from .the ■ AclingJnspeetorrGencral ■ of Hospitals regarding the proposal of the Board for the appointment of medical practitioners as health officers. The writer stated that the system of appointing local medical practitioners as medical officers of health had been tested in England since 1870, hut the system had not been a success, and medical officers of health for counties and larger bodies, who are whole-lime medical officers, were again being appointed. After the department was established in .New Zealand in 1900 the same system was given a trial in several districts, but it proved; a. total failure. Among the weak spots in the system u as that the average medical practitioner had no practical knowledge of public health questions, and that be very frequently raised, quite unnecessary alarm in the public mind, and took measures quite in excess of those really necessary. This was due to a commendable desire to be on the safe side in his precaulions, but.the excessive measures would bo avoided by those with more experience in the work. Pew medical men had any real knowledge of plumbing and like sanitary rules, and their reports on the condition of houses where infectious diseases have"arisen were, therefore, of little value. The writer further stilled Inal where a medical man in practice'was engaged in reviewing the decision' of brother.medical practitioners in regard to infectious-dis-eases a source of jealousy and suspicion was.at once opened, and tin’s was the outstanding feature in the work of the local medical officers both in England and in New 'Zealand.' Actual eases arose where the. medical officer used unfairly the advantage his official appointment gave him over brother medical men, and in a great many more the medical officer was unfairly suspected to be seeking such advantage. The Department would never care to report the experience of those earlier years. The criticism of the sytsein in force were: That the District Health Officer had 100 large an area to permit of his giving sufficient detailed inspection at any one part; that the investigat ion of disease was in the hands of a lay inspector; that il e inspector avus not under the instruction of the Hospital Board as to his duties. Continuing, the writer stated that in regard to the conditions in Palmerston North he could not think that there was any • evidence that the sanitary needs had been neglected under (he .present system, since the records, of infectious diseases notified had been lower than in most’disfricts for the past few years. Owing to the growth of population, however, il had been decided to place two inspectors (instead of one) in the district. In regard to lethargic encephalitis, much bad been made of the occurrence of tlirqc cases in the Board's hospital district, and statements calculated to alarm the public bad been needlessly circulated. As a matter of scientific fact, this disease need not be regarded with apprehension. It had been known (though not classified) since 1890, when the last pandemic of influenza occurred. The remedy for any defects in Hie present system of control was to be found in strengthening and extending the present staff of the Health Department so that more time to attend to details would bo afforded to the district health officers and inspectors. Such a scheme 'would be more effective and infinitely less costly than the scheme proposed by the Board. The Department looked to the medical practitioner for help, and sought his co-operation, and in by far the majority of eases the practitioner recognised his duties to the public in matters affecting the public health, and.willingly gave this co-operation, The Department thus secured the services of hundreds of medical men in place of only a few, whose special appointment Would alienate a considerable proportion of the remainder.

The 'Foxton Borough Council wrote, .stating that it was of the opinion that that district is being admirably served by the present medical practitioner, and it could not see any gain in the Board’s proposals. The .clerk to the Levin Borough Council, in the course of a letter, stated that his Council did not consider that medical men in private practice, could, satisfactorily assist in borough sanitation duties, and also recommended that more health inspectors be appointed for the district. The Palmerston North Borough Council wrote stating that it considered the appointment of a medical officer of health in the Board's district should be raa.de by the health authorities, who should also be asked to provide an adequate salary for such officer'. The Depart mem of Public Health notified that the second inspector to be appointed to the district would be appointed by the Department, and bis salary, and also that the increase in the present inspectors salary, would be paid by the Department, Dr. Whittaker said the letter was full of half ’truths, but unless there was somebody to oiler criticism nothing in the way of progress would be carried out by the Department. He did nut think the writer of the letter had been in England for 10 years, because the local bodies there 'were offering high salaries to medi-

cal’men/and there was competition amongst medical men for the positions. Conditions in England were much better than they were in New. Zealand, but the public health service here was trying to collect everything into its own hands. If this occurred il must attract young men who were frightened of the stress of private competition. The Hospital Board had tried to keep the Department in a stale of activity and liad succeeded to a considerable extent, and by its criticism had saved the expense of the in-.-.j lector's salary. He referred to the report of the public health service regarding reorganisation, and said it was impossible to put all bacteriological work under the Department. He said they would never get the right work out of the bacteriological laboratory if the Board was to have no say in the matter. Continuing, Dr. Whitaker said that he had written a letter to the Public* Health Journal that had been refused publication, after it had been forwarded by . the chairman of the Board (the letter being in reply to criticism by Dr. Makgill). Mr J. A. Nash said that some lime ago he had unsuccessfully tried to gel the Board to convene a conference of local bodies to consider (he question'' of (bo appointment of 'a medical inspector. They did not. know if they were going to have a recrudescence of the epidemic, and he Was sorry the Board had not agreed to this conference-being held. Mr J. K. Horublow said he was glad to know that the overlapping bet ween the Board and the Department would be done away with, and that the inspector would be controlled by the Department. lie.also thought, the reply to the letter in the Public Health Journal should have been published. The local bodies iu the districts would how know that they were responsible for their own sanitary inspection. He moved: “Thai the Board urges on the Mints ter to insert in the Public Health Journal the opinion of the Board, as voiced by Dr. Whitaker, in reply Jo Dr. Makgill." This was seconded by Mr F. Penn. The Chairman (Sir James Milson) said that Dr. Makgill's reply to Dr. Whitaker was published in the Health Journal, and ho did not think it was fair that Dr. Whitaker’s reply was not - also published in the Journal. Mr Ilurnblow’s motion was carried unanimously.