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As a word of warning, I feel bound to point out that disappointment with the
results is likely to occur unless the dispensary is able to help, either directly or
indirectly, in the way of provision of nourishment in suitable cases, in that of
finding occupations for those suffering, and also for those who have returned from
a sanatorium, and who if they resume their previous occupation are almost ceitain
to go under. (Signed) FRANCIS STEVENS, Medical Officer of Health.
The matter was again considered by the Committee in April
and adjourned for three months to see how the institution was
working at the end of that time. As it was understood that some
scheme was in course of preparation by the London County Council
it was again adjourned.
In consequence, however, of a wish expressed by the Medical
Officer of Health to the Local Government Board as to the provision
of a dispensary, I reported on November 20th:—
Gentlemen, —The opinion of the Local Government Board is that arrangements
for the provision of dispensaries, which are to be centres of diagnosis and treatment
as well as receiving houses, should be made by Borough Councils either singly or in
groups where small districts are concerned; they also express a wish that I should
report to you on the subject.
The Camberwell Dispensary for the Prevention of Tuberculosis has been started
by voluntary effort, aided by a Central Fund, and is managed by a local Committee.
It consists of a house in Brunswick Square which lias been properly fitted up for the
purpose of a dispensary, with a staff of a medical officer, nurse, and caretaker, and is
in actual work. Patients are seen there, and treatment at home of those who have
been attending there is also undertaken. This dispensary has been provision lly
approved by the Local Government Board, subject to certain conditions they have
imposed, for a period of six months from July loth, 1912.
The point lor this Committee's present consideration is whether they will themselves
provide a dispensary or make use of the one already in their midst. Any
measures dealing with tuberculosis must be considered as a part of the general
health administration of the Borough, and must consequently be a duty and
responsibility of the sanitary authority and its officers.
It seems, therefore, that any recognition of the existing dispensary as fulfilling
the duty imposed by the Local Government Board must be accompanied by some
means which will ensure that this authority is the principal controlling force in its
management. Whether this should be achieved by appointment of members of this
Public Health Committee who would be in a majority on that of the dispensary, or
whether a definite bargain should be struck setting out that in return for financial
help from this authority the governing body of the latter will agree to carry out our
requirements, is now to be decided. This bargain in the main would relate to their
undertaking an agreement for their medical officer to examine any person of the
family of the patient notified to me, the notification of any insanitary condition,
to keeping under observation the members of the household, in other ways
to answer any question on which they are in a position to give us information,
and to agree to and to carry out the arrangements we should make
in the way of elimination of overlapping and over-inspection. This second
plan seems to be the better, for there will be fixed principles governing the
relations between the two bodies, and subsequent friction in working is most
likely to be obviated. If, on the other hand, the Council should decide not to
recognise the dispensary, and themselves inaugurate an undertaking on similar lines,
the initial cost of fitting up an establishment, roughly, would be about £250, and
with an expenditure of at least £800 annually. The financial assistance received
by the Borough Council if they themselves start a dispensary will take the form of
payment for those insured persons who are treated there in accord with the conditions
imposed by the Local Government Board, and certain other assistance would be likely
to be given for the non-insured if the dispensary should form part of a scheme approved
by the Local Government Board. My reason for saying this is that at; a conference
between the Local Government Board and National Insurance Commission and the
Metropolitan Medical Officers of Health it was asked whether any legal obligation or