9

H.—3la

ing. In Australia the disease appears to have gained admittance under very strict quarantine conditions. The medical testimony throughout favours the isolationist' persons infected by this disease, and where isolation has been applied to a place it appears to have in a degree prevented the spread of infection, and, consequently, minimized the evil. The Commission has heard strong views expressed in favour of applying practically quarantine conditions to all infected districts within the country, but is not prepared at this time to advise such a course of action as being necessary. Health Department Initiative. We recommend that in order to meet a possible recurrence of the epidemic the Department be added to in the administrative, medical, and sanitary branches. A strong policy of definite initiative on the part of the Head Office and of all district centres is essential. The services which the Department will irndertake in the way of advising or directing the local authorities, and the specific tasks which it will carry out by means of its own officers, should be fully and clearly defined. All departmental branches, the several local authorities, and the citizens organizations directly concerned should be early informed of the scheme of operations to be followed, and the specific services required of each of them. The Minister and the Department should concentrate their attention upon co-ordinating the whole of the forces required to combat the epidemic, and lead the country in creating precautionary safeguards before the attack has reached the stage of virulent intensity. The Duties of Local Authorities. The first, if unwritten, duty of the local authorities is to energetically assist the Minister of Public Health and his Department in all measures necessary to combat this grave danger to the Dominion. Though by section 5 of the Hospital and Charitable Institutions Amendment Act, 1910, the Hospital Boards are constituted local authorities for " the prevention of infectious diseases," and the Boards are therefore legally placed in a leading position as regards the duty of combating any infectious disease, yet it should be clearly understood that in dealing with an epidemic the duty falls upon every local authority to help in stemming the torrent of disaster. The Borough Councils, Town Boards, and County Councils should each appoint a Health Committee, and be ready to act with the Government and voluntary organizations. The important matters of sanitation, house inspection, ventilation, and general hygiene should have special attention. The Councils and Boards referred to might also consider what monetary or other assistance they can give to the associations carrying on nursing or other special work within their district. Hospital Board Work. A Special Epidemic Committee should be appointed by each Board, and each such Committee should make arrangement with respect to — (1.) Auxiliary and temporary hospitals throughout their district. (2.) The providing of full nursing staffs. (3.) The securing of medical services for all institutions. (4.) Establishing of dispensaries where required. (5.) Assisting in regard to transport. (6.) Co-operation with the general organization throughout their district. (7.) Give special attention to relief and supply of reserve assistance in respect to the medical and nursing services. To the credit of the Hospital Boards it can be said that from the earliest stage they entered fully into the work of combating the recent epidemic, and we have been informed that the Boards in several districts have appointed Committees as herein suggested, and made tentative arrangements. Each Board should, as early as possible, compile a list of its various requirements, and copies of these lists be supplied to the Health Department in order to secure general supervision over the whole Dominion.

2—H. 31a.