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I—16
order in which a grant for a dispensary may be made. The Local Government Board
representative answered: "That the Chancellor of the Exchequer, in answer to a
deputation, said .... that so far as insured persons are concerned, it may be
assumed that the authority running the scheme of institutional treatment would
receive the actual expenditure on the insured. Then there are the non-insured twothirds
of the population. So far as they are concerned, he is willing to pay half the
cost if the local authorities will pay the other half." This probably relates to any
scheme elaborated by a local authority, and which would probably be essentially
one including all the requirements of the Departmental Committee set out above.
It is obvious that the inspection of contracts of the notified people who are of the
non-insured section will reveal cases of incipient trouble which may very well be
treated in institutions. But it is little use going to the expense of diagnosing such
early cases unless it is possible to carry out the idea of home or institution treatment
as recommended by the Committee, and it will be necessary to make some arrangements
with sanatoria or kindred institutions for a certain number of beds which can
be used by this authority to send cases to ; and this may also mean a certain
number of beds for observation at a dispensary. I think it is the better plan to
make use of the existing dispensary, provided that a satisfactory arrangement can
be come to with its authorities. It will save time and trouble with regard to the
finding and equipping of suitable premises ; it will probably be less expensive than
our own undertaking of the whole of the cost; and further —and this is. perhaps, one
of the most important things—we shall gain voluntary helpers who, besides taking
what I may call a local interest in its success, will interest themselves in the way of
helping persons attending there to find employment more suitable to them, will to
some extent be able to arrange for material help, and by whom this had best be
supplied, and also for assisting those who are in need of removal to convalescent
homes or institutions. None of these would, I think, be so well done by a purely
municipal dispensary, yet without them the results of the work of a dispensary
itself would be, I fear, a grievous disappointment.
(Signed) FRANCIS STEVENS, Medical Officer of Health.
An answer was duly received from the Board in which they
stated they were inclined to agree that this was a case in which this
Council should not themselves provide a dispensary, but should
make the necessary arrangements with a view to the existing
organisation serving as the main tuberculosis dispensary for the
Borough, and any branch dispensary that might be found necessary
to be worked in association with it.
Many meetings were arranged between the representatives of the
dispensary and ourselves since December, 1912, but at the time of
writing nothing final has been arranged.