Dr. R. Deane Sweeting's report to the Local Government Board upon a re-inspection of Ilkeston Borough : with especial reference to the use of the hospital for infectious diseases there.

  • Sweeting, R. Deane.
Date:
1911
Catalogue details

Licence: In copyright

Credit: Dr. R. Deane Sweeting's report to the Local Government Board upon a re-inspection of Ilkeston Borough : with especial reference to the use of the hospital for infectious diseases there. Source: Wellcome Collection.

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    Ventilation of the wards seemed satisfactory, and they were not crowded at my visit. There ’were only four scarlatinal convalescents in them. The staff consisted of a matron, a nurse, a servant and a man (for disinfecting &c.). Sewage is conveyed to a small cesspool, oO yards from the building. It is emptied monthly, the contents being pumped into a tank-cart and taken to the sewage farm. Though pleasantly situated, this hospital cannot be said to be in accordance with the Board’s views and requirements. It is of un- substantial structure ; all the four w^ards are in aerial inter- communication ; there is no separate administration ; the staff' sleeping accommodation is bad ; there is no proper accommodation for more than one disease at a time ; the laundry is inadequate. Appendix A shews that during the eleven years 1899-1909, enteric fever, scarlet fever, small-pox and diphtheria have at one or another time been isolated in this hospital. But, of the total 1,453 notifications of these infectious diseases during this period, only 140 or less than 10 per cent, have been isolated in hospital. The percentage of isolation was for scarlet fever T7, for diph- theria 2*5, for enteric fever 22, and for small-pox 43. As bearing on the question whether this small proportion of isolation was due or not to the fact that the town council expected (if they did not actually enforce) payment for treatment there, I have added a note to the return showing the numbers who paid and how many were paid for by the Basford Guardians. It is seen that 79 of the 140 paid for treatment (— about 56 per cent.) of whom 59 w^ere paid for by the guardians. These were admitted on the order of the relieving officer. The number Avho paid has diminished considerably of late years, and none seem to have paid since 1907. And yet the number of isolations does not seem to have increased since then. It is difficult to appraise this factor of payment, but, on the whole, I think it tended to render the hospital unpopular at the first, and that the unpopularity has remained. I was told that the town council do not now insist so rigorously on payment as formerly ; but the inspector of nuisances still has to obtain signature to-the form shewn in Appendix B, though payment is now seldom exacted. But the principle is bad, and does not tend to popularise a fever hospital in a working class borough like Ilkeston. I was also informed that the medical men, for pecuniary reasons, would not let their patients go to the hospital. This I can hardly accept, and I am disposed to refer the failure to secure a greater amount of isolation to the medical officer of health having displayed little or no interest in the matter. It passes my understanding how, in his letter to the Board of the 30th June, 1910, he could describe the hospital accommodation as ‘‘ ample and well-fitted for the purpose for which it is provided ; it has served the needs of the borough admirably for the past twenty years.” I have little doubt that the above failure to secure hospital isolation has, in the circumstances of housing in Ilkeston, led to a much larger incidence of infectious disease than should have occurred. Taking the mean population in 1899-1909 at about 28,000, an average yearly incidence of some 132 cases of the