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THE VACCINATION BILL. Mr. Edwin Lankester, Medical Officer of Health, of St. James's, Westminster, London, desirous of showing how the Vaccination Bill, now before the House of Commons, will probably operate, writes the following to a contem- porary :— Allow me through your columns to call the attention of the public to the objectionable nature of the Vac- cination Bill which is now passing through the House of Commons. In the first place, this bill continues in the hands of the Poor Law Board the control of vaccination throughout the country. From Lord Robert Montagu's speech the other night, it will be seen that, although that board has hitherto had all control in the matter of vaccination, upwards of 20,000 persons died of this disease in England and Wales in three years, from 1863 to 1865. Where one person dies of small-pox, at least ten catch it and recover. If the cost of each case be put down at 51., some idea may be formed of the money loss which has thus been incurred by the incompetent manner in which previous Vaccination Acts have been carried out. Is it wise, humane, or economical to trust the same body with powers which it has shown itself so thoroughly incapable of carrying out ? The next objection to the present bill is that it pro- vides for no compulsory registration of births. The success of the Vaccination Act for Scotland has en- tirely depended on the fact that there is in Scotland an Act rendering the registration of births compulsory. No such Act exist in England and Wales. This de- ficiency in the law of England has been pointed out first to Mr. Bruce and then to Lord Robert Montagu by deputations from vestries and medical officers of health, and they have been warned that any com- pulsory Vaccination Bill without a compulsory regis- tration of births must be a delusion and a snare. It is well known that in many districts of England, especially in London, a large percentage of the births are not registered at all, and no machinery of the pre- sent Vaccination Bill can reach the case of these unregistered children. As the demand for vaccination must follow on the birth of a child, it would be much better that the super- intendence of vaccination should be placed in the hands of the Registrar-General, who, with a compul- sory Registration Act, would be in a position easily to register the performance of the operation of vaccina- tion without the cumbersome provisions of the present bill. The present bill is framed to introduce a costly system of inspection. If the money thus proposed to be spent were paid to intelligent medical men for the performance of vaccination, the same end would be gained. What really makes the success of the operation doubtful at present is the contemptible sum that is paid the public vaccinator. It is a well- known fact in parishes where the minimum sum of one shilling has been increased by the board of guardians that their medical men take more in- terest in looking after the children to be vaccinated and small-pox is less frequent. The life and health of the community ought not to be a subject of pounds, shillings, and pence but there can be no doubt that the prevalence of small-pox in a district could be pre- dicated with tolerable accuracy from the sum paid for each case to the public vaccinator. I am not prepared to say what is the minimum payment that would give the largest amount of vaccination, but it would cer- tainly be nearer double the amount offered by the present bill than any intermediate amount. On the above letter, in support of Dr. Lankester's state- ment, Mr. J. W. Barrett, a Public Vaccinator, of King's Lynn, makes the following observations:- Dr. Lankester says very truly that "a large number of children in. England go unregistered, and that no machinery of the present Vaccination Bill will reach these children." Now, I wish to suggest the propriety of making the registration of births compulsory within three months after birth, and of the parents being re- quired to produce a certificate from some duly qualified surgeon, of successful vaccination having been per- formed, without which the registrar should be in- structed to refuse to register the birth. This would, I think, give an opportunity for all medical practitioners to become public vaccinators, and would obviate the unpleasant duty which is at present incumbent on every public vaccinator who does his duty, viz., that of calling upon his professional brethren's patients to see that thJir children are vaccinated. In support of this I would say that many private practitioners who have no interest in vaccination, do not even encourage their patients to comply with this very necessary operation and with regard to their poorer patients, who cannot afford to pay for vaccination, after the labour is at an end and the fee paid, the infant is allowed to go into the world wholly unthought of; and when the-public vaccinator requests that he may b allowed to vaccinate the child, he is told "Dr. So- and-so is my medical man, and he's going to do it;" and unless the public vaccinator takes the trouble to call two or three times, Dr. So-and-so acts (probably without knowing it) as a cloak to cover a small-pox bed.








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