In accordance with well-worn usage London had been left behind in this matter. Other cities and even towns had, by means of local Acts, secured the advantages of such legislation long before. So far back as 1874, indeed, machinery had been in existence in London for the notification of infectious disease in houses let in lodgings. But owing to the neglect of the majority of the Vestries and District Boards to make or enforce regulations under the Sanitary Act of 1866, that machinery was left unused to the great detriment of the people of London. Thousands of lives must have been sacrificed by this neglect, and innumerable cases of preventable disease not prevented. It was not until a general Act was passed that London became possessed of the advantages resulting from such notification.
In London, indeed, the health of cattle was better looked after in this respect than that of the people, for cases of infectious disease in cattle had to be notified to the Sanitary Authorities.
By this Act it was made compulsory on medical attendants to certify, and on householders to notify, the existence of any of these diseases.
Hitherto information as to infectious illness only reached the Medical Officer of Health after a sufficient time had elapsed to allow of the spread of the infection.
The results of the Act of 1889 were soon found to be very beneficial in checking the spread of disease.
The receipt of the notices of infectious diseases led to the more prompt and general disinfection of premises where infectious diseases prevailed, and led also to the discovery of sanitary defects which might not otherwise have been discovered.
The information, moreover, kept the Medical Officers of Health informed of the progress of disease not only in their own districts, but also in contiguous ones, and so assisted them to take prompt measures for the eradication of disease in their respective districts.
The other measure which passed the legislature in this same year contained provisions of the highest importance as affecting the metropolis. This was “the Poor Law Act, 1889.”
Until 1889 patients could be admitted only to the infectious hospitals of the Metropolitan Asylums Board on the order of the Relieving Officer and District Medical Officer, so, except in certain cases, the hospitals were only open to Poor Law cases.
This measure made practical concession of two principles. Free admission to the hospitals of the Metropolitan Asylums Board of sick persons in need of isolation, and devolution upon the Metropolitan Poor Fund of all charges incurred in the maintenance of the sick in those hospitals.