Sent from H. A. Leggett
20 Dec 1928
Description:

‘Sir,

I am directed by the Minister of Health to state, for the information of the Lords Commissioners of His Majesty’s Treasury, that the arrangements for providing adequate assistance for the work in connection with the malarial treatment of persons suffering from General Paralysis of the Insane has once more been under his consideration.

When the work was originally undertaken by the Department the treatment was entirely in the experimental stage and it was, therefore, essential that the supply of mosquitoes and the control of the treatment should be in the hands of the Ministry. It now appears possible that it shortly will emerge from the experimental stage into a definite and recognised system of treatment. This stage has not, however, yet been reached. There is still difficulty in securing that the mosquitoes are infected with the right type of malaria; the treatment, while becoming more and more recognised, is still looked at with some apprehension by certain of the Medical Superintendents of Mental Hospitals, and these Medical Superintendents still need careful instructions in administering the treatment; and it is essential that all the results should be closely watched and studied in order to perfect the technique of the treatment; and it is essential that all the results should be closely watched and studied in order to perfect the technique of the treatment. It is further the case that was this is the only definitely positive treatment for General Paralysis of the Insane that has ever been successfully tried it is vital that, until the technique is definitely settled, the present control should not be diminished.

While, however, the experimental stage cannot be yet said to be over, it is felt that the experiment is sufficiently advanced to justify the consideration of the future to ascertain whether, and if so, by what means full financial and other responsibility for the operation of the system, subject of course, to such central medical supervision as may be necessary, should be placed on local authorities.

The Minister is not yet in a position to give any indication of the date from which the full control now exercised can cease, and though it is clear that the present arrangements are of a temporary nature only and cannot involve the Department in any permanent commitments, it is probably that the present arrangements must necessarily continue for the next two or three years.

The general medical control of this work is exercised by one of the Medical Officers of this Department but, since the latter part of 1927, it has been necessary to supplement this by obtaining the services of one of the Medical Officers of the London County Council employed a the Horton Mental Hospital, the Minister paying for the cost of the substitute of this officer out of the Special Inquiries and Services Subhead of the Vote. This arrangement comes to an end on the 31st March, 1929, and the Minister does not propose to renew it. The duties of the Medical Officer consist partly in the general supervision of the care of the patients and of the laboratory activities at the Horton Hospital and partly in taking infected mosquitoes to different hospitals throughout the country for inoculating patients and giving advice on the care and management of patients.

The London County Council is prepared to allow the Deputy Superintendent at Horton, who is fully cognisant with this work, to perform the necessary supervision of the patients at that institution, without any payment by this Department, and the Minister is now satisfied that, as most of the other hospitals have been visited at least once and the necessary precautions taken and management of cases are more widely known, the work of visiting the various hospitals with infected mosquitoes can in a number of cases now be devolved upon a competent laboratory assistant.

There are at present two Laboratory Assistants employed by this Department on this work; one a permanent officer who is specially qualified, and the other a temporary officer whole employment was sanctioned for a period of one year by Sir H.H. Scott’s letter of the 15th October, 1927. (E.4102/2).

If the work of conveying infected mosquitoes to the various hospitals is in general to be performed by a Laboratory Assistant, it is necessary, not only that the employment of the present temporary laboratory assistant should be continued, but that an additional officer should be appointed, who, having regard to the considerations set out above, the Minister would propose to be a temporary office.

The Minister would accordingly be glad if Their Lordships would be please to approve, for a period of two years,

(a) the continued employment of the temporary woman laboratory assistant sanctioned by Sir R.R. Scott’s letter of the 15th October, 1927.

(b) the employment on a temporary basis of an additional laboratory assistant on the scale applicable to a Second Class Laboratory Assistant, viz. £91.5 - £5 - ££120 per annum plus bonus.

I am, Sir,

Your obedient Servant,

H.A. Leggett.’