§ Mr. BROMFIELDasked the Minister of Health whether he is aware that 31.5 per cent. of the cases notified as diphtheria, and 13.6 per cent. of the cases notified as scarlet fever, and sent to the infectious diseases hospitals of the Metropolitan Asylums Board in the year 1924, were found after admission to be suffering from something else or from no disease at all; whether there is any reason to believe that these percentages are as great or greater throughout the country; whether any steps are taken to correct the statistics of notification for these errors; whether the parents of the children are informed as to the mistaken diagnoses; whether there is any information available as to how many, if any, of these cases contract diphtheria or scarlet fever after admission to hospital; whether the practitioners who make these errors are called upon to refund the notification fees received by them; and, if not, will he consider the desirability of arranging for that course to be adopted?
Mr. CHAMBERLAINThe answer to the first part of the question is in the affirmative, but I may say that I am informed that the increase in the number of cases of diphtheria admitted during 1924, to the infectious diseases hospitals of the Metropolitan Asylums Board in which the diagnosis had to be revised may be accounted for by the increasing recognition on the part of medical practitioners of the necessity, in the interests of the patient, of immediate removal to hospital for the purpose of securing treatment as early as possible without waiting for the receipt of a laboratory report.
As regards the second part of the question, no figures are available for the country as a whole which would enable any definite conclusion to be arrived at. As regards the third part, I am informed 2187W that in cases in which the diagnosis made at the Metropolitan Asylums Board's hospitals is not in agreement with that of the notifying practitioner, the information is communicated to the medical officer of health of the sanitary district from which the patient was removed in order to ensure the accuracy of his statistics. As regards the fourth part, I understand that information as to the diagnosis made at the hospital is given to the parents on request. As regards the fifth part, I am informed that there is no information available as to the number. if any, of these cases which contract scarlet fever or diphtheria after admission to hospital. As regards the last part of the question, I am advised that there is no statutory provision under which a medical practitioner could be called upon to refund the fee for a notification certificate in a case in which his diagnosis is not in agreement with that subsequently made at the hospital, and in view of what I have said in replying to the first part of the question, it would, in my opinion, be undesirable in the public interest that such a course should be adopted.