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As the Council had already been dealing with the Dispensary
authorities it was deemed advisable that the latter should meet the
King's College representatives and discuss the financial arrangements
which might be necessary in the event of the Hospital
becoming associated with the Dispensary. The Hospital eventually
decided that they could not make themselves responsible for
the treatment of tuberculous cases in any particular area of the
Borough in the absence of any undertaking by the Borough Council
to provide for the additional expense which must be incurred, but
that they would always give special consideration to any cases
referred either from the Borough or from the local dispensary.
The Public Health Committee then re-considered the original
draft agreement, and resolved to recommend its adoption as
amended (see above).
As there was a question of money payment the resolution had
to be submitted to the Finance Committee, who made no recommendation
to the Council thereon. The whole matter therefore
remained in abeyance for the time being.
On September 30th, on the receipt of a letter from the Local
Government Board relating to the work of the London County
Council in regard to the provision of dispensaries, the Committee
decided to re-affirm their resolution in favour of an agreement being
entered into between the Council and the Camberwell Dispensary.
The Sub-Committee which had conferred with the Dispensary
was re-appointed in November, 1913, but no negotiations have been
resumed.
Of the total notifications which were received during the year
372 were received from the Dispensary, and of these 75 were secondary
reports of relations of a previous case. These secondary cases
were in eight instances associated with primary notifications by
other medical men.
It is thus evident that the voluntary dispensary is doing the
work which would be done by a Borough institution, but with this
difference, that it costs the ratepayers nothing. It is not within my
duty to blame or praise this arrangement, or rather the lack of it;
but granted the benefit of a dispensary, there are many reasons why
the Borough Council should be associated with its working, for the
examination of the remaining members of a patient's family takes
place as a matter of course in the dispensary patients —witness the
75 cases mentioned above—but in those only notified to me it is not
possible to institute an examination from the tuberculosis point of
view of the whole of the family, and I am perforce compelled simply
to advise the head of the house to obtain treatment for the more
obvious cases, whereas had we been connected with a dispensary
the address would have been forwarded to them to seek out any
early or hidden cases therein and to get them into the best way
towards a cure.
It is not necessary to again urge the advantages of an arrangement
with the Dispensary, for they have already been set before the
Council, but I would point out that the practice of economy is in