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55
It is clear from the position which the Tuberculosis Dispensary occupies
in the Scheme recommended by the Interim Report that it must necessarily
become the centre for co-ordinating the various agencies in the Borough for
fighting Tuberculosis. The Dispensary (after notification) will be the first
step in the preventive measures to be taken in connection with Tuberculosis as
such Dispensary would be the receiving house and clearing house for all cases
within the district, acting as a centre for observation and diagnosis; and in
connection therewith the patients would be able to obtain curative treatment
at the Dispensary or at their homes, together with a subsequent Institutional
treatment as required elsewhere than at their homes, e.g., at a Sanatorium, a
Hospital or a Convalescent Home (excluding Poor-law Institutions), followed
by "After Care" treatment. The Dispensary would also act as an Information
Bureau and general Educational Centre for Tuberculosis. The Departmental
Committee in their Interim Report suggest that Tuberculosis Dispensaries
should be provided by the Metropolitan Borough Councils in so far
as London is concerned.
All are agreed that Dispensaries are needed and that such Institutions
should be established and maintained in each Borough (the estimate suggested
in the Report is one Dispensary for every 200,000 population).
It is, however, to Municipalities that one must look for the best results
in checking the ravages of Tuberculosis and for preventing its further spread.
As has already been pointed out in this report, such bodies are the Sanitary
Authorities entrusted with important powers for dealing with infectious
disease. On grounds of efficiency and economy a Municipal Dispensary for
the treatment and prevention of Tuberculosis would be the best for each
Metropolitan Borough, and much overlapping of administration would there by
be avoided. As it is, all notifications of Consumption have to be sent to the
Medical Officers of Health and recorded by them in private registers, and all
preventive measures necessary have to be taken by the Councils' Public
Health Staffs. To systematise this work, and for the purpose of obtaining the
maximum value subsequently from the information obtained, a Tuberculosis
Dispensary is absolutely necessary. At such an institution all cases would be
classified for treatment (a) at their homes, or (6) in some institution. Until
the "Sanatorium Benefit" provided by the National Insurance Act came into
operation, though the Borough Council were aware of a large number of cases,
practically very little or no provision was available for their efficient treatment.
Excluding the Poor-Law Dispensaries and the few special Tuberculosis
Hospitals, there were no institutions to which such patients could be sent.
These institutions must now be provided under the provisions of the Act, and
the Borough Councils are the proper Authorities to undertake this important
duty, and to arrange to provide a scheme whereby the best results may be
obtained. Tuberculosis is now a recognised infectious disease, and should
consequently be under the care of the Borough Councils through the Medical
Officers of Health as in the case of all other infectious diseases. Merely
to give a Council a representation on a Voluntary Institution would be
insufficient and unsatisfactory and would only increase difficulties of administration.
There are in Battersea two Dispensaries which have been officially
approved by the Local Government Board for a period of six months expiring
early in January, 1913. One is known as the Battersea Tuberculin Dispensary,
and is, I believe, more or less a private Institution. The other, in the establishing
of which I have been associated, is the Battersea Dispensary for the
Prevention of Consumption, a voluntary organisation, and has been open for
the reception and treatment of patients for the past twelve months. The
period for which the Dispensary was approved is now rapidly drawing to a
close, and the object of the Board in provisionally approving these Dispen