KELVIN HOME INQUIRY

Nelson Evening Mail, Volume LVI, 15 August 1924, Page 2

KELVIN HOME INQUIRY

COMMISSION H IIEPOUT

DIRECTOR-GENERAL'S COMMENTS NEGLECT IN, 01 ; CASES

In liia report-upon (lie- findings of llu 'Kelvin Commission, tlie Director-Genera :of Health (Dr. T. H. A . Vulintine) re ntHrlU'tl that surely some more stringent criticism of the medical practitioner: concerned, v.as called for in respect t<

the neglect, (a conduct,'bacteriological ex animations as an aid to early arid aceui age diagnosis.- In three eases no bac teriological examination was made and in two'ensr-fc it vlimilfl have Ijcrn earlier

I lie Department had organised « systen throughout , the Dominion whereby facili- ■ ties were freely:available for the exam ination required in these eases. Hu Commission had failed to emphasise the fact, that notification was required forthwith in any ease where' the symptoms created a reasonable suspicion find the disease was a notifiable one the Department was dependent for its knew iedgo of cas'>s of puerperal sepsis upon the system of notification by''medical ■practitioners. Unfortunately, in some eases notifioition was delayed or was

even suppressed. It was imperative that the fullest information be supplied to tin: Deportment at the earliest possible moment, a» default or delay might bo followed by tilts.most "serious results. Once a citsj had been notified the De pitrlmeiit must assume full responsibility Over all measures to eliminate the- fur-

ther gptefid of infection, Out of the five eases that occurred ill Auckland, only otic Was promptly notified as such. Of the remaining cases, one Was not notified at all; one was notified as a result of post-mortem examination; one was notified in a- most indeterminate manner by letter,'arid not by the statutory form; ■while*the. fifth was notified only after a regrettable delay. This was a strong indictment of the members of the medical profession concerned, and surely it

called for strong comment. Nothing is more outstanding in the report stated the Director-General, than the unmistakable tendency ot the Commission to minimise any dereliction of duty on tile part of tho medical pro fession and to turn a most severe eye on any dereliction of duty on the part- ot (ho Department. The Department has

found the. profession so unreliable m this .matter of notification of puerperal sepsis that it has been forced in its draft regulations to make compulsory the notification of'the fact of continued

temperature; in maternal cas.es. It ;s very’noticeable that there is no mention of this suggestion which was put before the. Commission by the departmental officers in Auckland. . ... Jn .regard to the recommendation of the- Board of Health that every case of maternal death and of notified puerperal sepsis should be forthwith personally investigated by. the Medical Officer of Health;. Dr. Valintine said that in no

district of the Dominion had it been possible to comply with the recommendation, . although "earnest attempts had

been mado to do so. With such -large health districts as were the rule in New Zealand, and with the very limited staff, it was a physical impossibility for the Medical Officer of Health to give sufficient time to-attend to this particular type of infectious disease.- * The Commission was pleased to com-

ment adversely on Dr. Hughes’s action in visiting the cas.es of unknown disease reported irom Parnell, and to designate these cases as "trivial.” The Department could not agree with this Tim occurrence of » disease so- infectious as typhoid fever in a poor and overcrowded district could not be considered trivial by-any experienced Medical Officer of Health. Officers of the Department must always, place, public safety before any other consideration. Jii ils recommendation's,- the 'Director*. General comment-;. I. the Commission broke no new--ground. - «\s a nuitter.-of fact, draft regulations which were held .up pending receipt of the Commissions rejort'-provided for the taking of s-cps ■more; drastic than any suggested-bv the Commission, and touched the roots of the problem in a much better way than any of the .suggestions they made. T. n l.er the heading oftoGo-ordinotioii,” the Commission made , two recommendations. Thereiwere actually two proposals made fiy the Department in June last year to the Council of. the New Zealand brauoli of the B.M.A: The former recommendation .that: the licensee should notify medical practitioners attending the institution of any notified case of puerperal sepsis therein was agreed to by tnc council, and was duly put into effect by 1 lie Department. It. was no reflection on tho matron of .the Kelvin Hospital that such notices were, not given, to her by'the doctors in certain cases., Until the public hospitals were prepared to take up.tlic receptioti- of all classes of niatefnity cases the Department (could ' not take measures which would result in the closure of most, o( the private hospitals which at present were filling a very necessary role. In’-'Conclusion, the Dii ector-General emphasised the dependence of the Department :up*'m the good faith of the medical practitioners. and pointed our that nd svstein of inspection could be adequate in the abserce of such co-opera tion. Under-the War Regulations the temptation to delay information pr suspicious was being removed from the way ( of the medical practitioner, and notification was lequired of any case m wlucn the tempjratmv rose to ICO degrees I'. or over on any three days of the puerperium. l’his notification ivas to be made by the mation, independent of the medical practitioner. ' ‘ We hsfve recognised for: some time,” he stated, -hat the regulations in regard to private hospitals were unsatisfactory. In 1920 a draft Bill giving the necessary powers for complete regulations was prepaied, but it did not become law until Ist April, 1Q24.”' ,r ■ y '