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responsibility, but, as the Tuberculosis Officer can admit cases into beds under his charge, there is
little delay in securing admission in suitable cases.
Certain cases are recommended for Domiciliary Treatment but these are not numerous due to
the fact that many of the patients are domestic servants who leave South Kensington for their
own homes when a diagnosis of tuberculosis is established.
Owing to the small number of cases and the comparatively large staff available for the work,
there is little risk of the Dispensary arrangements becoming clogged by routine treatment of
ordinary cases.
An X-ray expert, a throat specialist, a bacteriologist and other physicians are always available
or consultative purposes and nothing is wanting in regard to the diagnostic and curative aspect
of the work.
There has not been any definite attempt to examine contacts, and only those presenting
themselves on the suggestion of the Assistant Lady Almoner and the Council's Women Sanitary
Inspectors are dealt with. The Tuberculosis Officer is, however, anxious to examine the contacts
of all notified cases in the South Kensington area and, in fact, he does not wish to regard himself
as a hospital physician in regard to South Kensington cases, but desires to become an Assistant
(Tuberculosis) Medical Officer of Health for the district. If more time be required, he is prepared
to give it, but there is a limit to the time available in the case of a consulting physician, and if
that be exceeded he is willing to arrange for a house physician to deal with surplus contacts.
Any suspects presenting themselves or referred for examination are dealt with as in the case of
those attending at the North Dispensary.
Home Visiting.—The Assistant Lady Almoner and nurses on the Hospital staff visit the homes
of patients on the Dispensary books; the nurses also perform actual nursing duties in the homes
when necessary. There is, however, no definite system of visiting every Dispensary case at stated
intervals and this question requires consideration.
The Tuberculosis Officer visits patients at home occasionally, but hopes to arrange for more
visits to be paid by a Hospital house physician.
Following up of patients ceasing attendance without satisfactory reason.—There is little difficulty
in securing regular attendance owing, no doubt, to the national reputation of this institution
and the fact that patients can secure both in-patient and out-patient treatment; nevertheless,
some persons become tired of any treatment.
Records of appointments given and attendances made are kept by the Assistant Lady
Almoner and those patients failing to attend on the appointed day are visited by this worker.
There is, however, no definite routine in the "following up" of cases, but the Borough Council's
Women Sanitary Inspectors have always found that efforts are made to secure continuous attendance
of definitely tubercular cases and suspects. There is an unofficial arrangement whereby the
Assistant Almoner notifies to the Public Health Department those patients who cannot be
induced to continue attendance. It works satisfactorily and should be placed on an official basis.
THE KENSINGTON INTERIM TUBERCULOSIS CARE COMMITTEE.
An Interim Tuberculosis Care Committee for the Borough was established in 1917. The
members are ladies and gentlemen interested in health matters, together with certain officials
engaged on work more or less associated with the welfare of tuberculous persons. The Committee
meet at the North Kensington Dispensarv on alternate Thursdays in order to receive reports in
regard to all new cases at both Dispensaries.
It is the duty of the Committee to investigate home and social circumstances of patients, to
consider reports by the Medical Officer of Health, the Tuberculosis Officer and other medical
practitioners and to make recommendations for residential treatment when necessary.
The Committee undertake certain arrangements in connection with the admission of patients
to sanatoria and endeavour to make satisfactory arrangements for their reception at home after
discharge and for proper after care.
DENTAL TREATMENT OF TUBERCULOUS PERSONS.
During the year, the Council approved of a scheme for the provision of dental treatment,
including dentures, for definite and suspicious cases of tuberculosis under Dispensary treatment in
all cases in which the same is necessary for the efficient treatment of patients likely to make
satisfactory recoveries. The treatment is to be limited to patients recommended by the Medical
Officer of Health.
By arrangement with the Kensington Dispensary Committee, the dental clinic has been
established on the premises occupied by this body at 119, Ladbroke Grove, and work
commenced early in 1921.
The Dispensary Committee have agreed to allow their Tuberculosis Officer to give anaesthetics
when requested by the dentist, and the Council will pay £25 per annum for these services.