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49
[1916
sultative capacity, the Board having pointed out that in no approved London
scheme had provision been made for the payment of honoraria to Physicians
inasmuch as Physicians had agreed to gratuitously render such services as
were required.*
In regard to the method of payment to the Hospital Authorities for the
ervices to be rendered in accordance with the scheme, the Local Government
Board have insisted upon the Hospital Authorities accepting the principle of
lump sum payments, and any financial adjustments that may be necessary are
to be made after the 31st March, 1918, the period for which the Board's
approval of the scheme has been given. Such lump sum payments will be
upon the basis of the estimates contained in the scheme. In consequence of
the acceptance of this method of payment the Authorities of the City Road
Chest Hospital stipulate that it is essential that they should have control
of the expenditure in respect of the Southern Dispensary. As this condition
differs from the provision contained in Part III. of the original scheme as to
the management and control of that Dispensary the Council approached the
Local Government Board and the Shoreditch Borough Council upon the
matter, and as neither of them raised any objection to the proposed condition
of the City Road Hospital Authorities the Council gave their assent thereto
and also similar consent in the case of the Great Northern Hospital if need be.
Under the altered circumstances the Council considered the question of
the amount to be contributed by the Islington and Shoreditch Borough
Councils respectively in respect of the cost of the services to be rendered on
behalf of each Authority at the Southern Dispensary, which is at the total
rate of £1,950 per annum. It has now been arranged with the Shoreditch
Borough Council that the cost incurred shall be borne equally by the two
Councils. For the period in question, which is until the 31st March, 1918,
the cost to this Council of the services to be provided at the Southern
Dispensary will be at the rate of £975 per annum, while the cost of the
services to be provided at the Northern Dispensary† will be at the rate of
£1,200 per annum. The gross total cost to the Council of the services to be
provided by the two Dispensaries will thus be at the rate of £2,175 per
annum. Of this amount it has been agreed that the London Insurance
Committee shall contribute £500 a year in respect of the treatment of insured
persons, and the Local Government Board have undertaken to contribute
one-half of the remainder, while the London County Council have agreed to
* The Medical Officer of Health always advised against the payment of £100 a year to each
of the four Physicians, but his advice was not accepted.
† This Dispensary was opened on 1st May, 1917