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BTS guidelines on TB
  1. P C OSUHOR, Retired Consultant in Public Health Medicine
  1. East Lancashire Health Authority, UK

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This excellent guideline,1 chaired by Dr Peter Ormerod, is very welcome. However, on page 888, under the headingPublic Health Law, an important Act has been omitted—namely, Section 47 of the National Assistance Act 1948, as amended in 1951. This requires a doctor (usually a public health doctor) to consider, through a legal process, the compulsory removal to hospital of a person following certain strict criteria—for example, old age and infirmity, living in insanitary conditions, unable to look after oneself.

We have been approached in the past to invoke Section 47 on a patient with tuberculosis, although such a request and actual use is, I suspect, negligible in the UK as a whole. However, its use is still possible and will also not “be undertaken lightly” as was correctly stated for Sections 37 and 38 of the Public Health Act 1984. An attempt to use Section 47 on a patient with tuberculosis some years ago was frowned upon when a doctor pursued the patient to a northern seaside holiday resort in order to execute the order on him.