View report page

21
treatment at the Dispensary is being more and more confined to those cases requiring expert
treatment and to those straightforward cases for whom other satisfactory arrangements cannot be
made.
The new line of action has a tendency to diminish the popularity of the institution with certain
patients; nevertheless the Dispensary is carrying out its true functions more genuinely than in the
past, and the amount of work to be done on these new lines is sufficient to occupy fully the present
staff. If more routine treatment be desired an additional Tuberculosis Officer must be appointed.
Home Visiting.—When a patient attends the Dispensary for any reason whatever his home
address is placed on the visiting list of the Dispensary nurses and removed from that of the
Borough Council's Women Sanitary Inspectors, and all responsibility for home visiting in regard
to that particular case is undertaken in future by the Dispensary nurses. The Tuberculosis Officer
gives instructions as to frequency of visits in certain cases but in others the nurses visit as often as
circumstances permit. There is no rule that cases must be visited at certain intervals and the
nurses arrange their visits in the light of their knowledge of home conditions. The number of
sessions per week on which the Tuberculosis Officer sees patients has been increased recently and,
as the nurses wait upon him at the Dispensary sessions, the time left available for home visiting is
reduced.
The periodical visiting of every tubercular case on the Dispensary list, whether in regular
attendance or not, is essential.
Following up of patients ceasing attendance without satisfactory reason.—Some patients pass
away to the care of other institutions or come under the treatment of a private doctor, others are
discharged on requiring no further attention, but there must be, in connection with every
dispensary, a large number who discontinue attendance without any satisfactory reason being
known to the officers.
The records at the Dispensary are so kept that it is possible to ascertain whether any patient
has failed to keep his appointment. These failures are "followed up" at the earliest opportunity
by a visit to the home at which the nurse tries to persuade the patient to re-continue attendance
and offers him another appointment with the Tuberculosis Officer. In the event of the patient
still failing to attend the Dispensary, further home visits may be paid, but there is no rule for the
guidance of the nurses and the extent of the "following up" is left to their own discretion.
South Kensington Tuberculosis Dispensary.
Under an agreement between the Borough Council and the Bromption Hospital authorities,
Dr. Burrell, one of the Visiting Physicians to the Hospital, is appointed Tuberculosis Officer for
South Kensington and all patients residing in that portion of the Borough south of Kensington
High Street who are referred to the Tuberculosis Officer under the Tuberculosis Scheme are dealt
with by him. He sees the patients at 2.30 p.m. on Mondays and Thursdays of each week, a certain
portion of the out-patient department being reserved for South Kensington Dispensary purposes
on these two afternoons. One of the Assistant Lady Almoners is appointed Secretary to the South
Kensington Dispensary and devotes roughly one third of her time to the work of preparing records,
interviewing patients and visiting homes; the remaining two thirds of her time are devoted to her
duties as Secretary of the Chelsea Dispensary, which is stationed at the Hospital. Chelsea cases
are seen on different days and by a different Tuberculosis Officer, but in other respects, the
Tuberculosis Dispensary arrangements for that Borough are similar to those for South Kensington.

This Dispensary is part of a large hospital which is essentially a treatment unit. Most
patients attend with the object of securing treatment and after a positive diagnosis is made, the
cases, if resident in South Kensington and otherwise suitable, are treated on days allotted to
Dispensary work, unless they have been referred by a medical practitioner for diagnosis only. If
residential treatment be needed, the patient is admitted to the wards of the Hospital or sent to the
Sanatorium at Frimley, which is a branch of Brompton Hospital.
In-patient treatment of insured patients must be approved by the Insurance Committee and
that of non-insured by the London County Council before these authorities accept financial