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45
be said that either of these conditions is fulfilled by the existing
Dispensary, and it is therefore urgently desirable that more suitable
provision should be made for carrying out the work of a modern
Tuberculosis Dispensary.
The Tuberculosis Medical Officer (Dr. G. Macdonald) reports as
follows:—
I beg to submit a report of the work carried out at the Battersea
Tuberculosis Dispensary during the year 1923.
During this year no change has taken place in the staff of the
Dispensary. As in previous years, the work is carried on in close
co-operation with the general practitioners in the Borough and with
St. Thomas's Hospital, the affiliated hospital. The visiting of the
homes of patients attending the Dispensary is carried out by the
Dispensary nurses, and unsatisfactory and insanitary home conditions
found to be present on inspection are reported to the Medical
Officer of Health in order that such conditions may be dealt with by
him. An endeavour is made to induce all notified cases of tuberculosis
to attend the Dispensary, but for various reasons it is impossible
to persuade all to attend. Efforts in this direction, however,
have proved more successful this vear than during any year in the
past, owing to the close co-operation between the Public Health
Department at the Town Hall and the Tuberculosis Dispensary.
Many patients are notified for the first time to the Medical Officer of
Health from Institutions, where such patients are inmates at the
time, and it is only on their discharge that they are able to attend
the Dispensary. On notification of discharge of such patients from
Institutions, visits are paid to the home with a view to attendance
at the Dispensary, the object being to get in touch with those
suffering from the disease in order to see that each receives the
appropriate treatment, and in order that steps may be taken to
prevent, as far as possible, the spread of infection to others.
There is still, unfortunately, a considerable waiting period for
patients between the recommendation for, and admission to, Institutions
under the London County Council's Tuberculosis Scheme.
This waiting period varies throughout the year, and is more marked
during the spring and summer months, but on an average over the
whole year it works out at 29 days. The long waiting period has a
bad effect on many patients, both on their physical and mental conditions,
and I am of the opinion that much good would result if the
waiting period could be reduced to a week or 10 days. Institutional
accommodation is limited, and this accounts for the long waiting
period and also for the premature discharge of patients from
Institutions in order that beds may be found for those on the
waiting list. All countries, apparently, suffer from the inadequate
number of sanatorium beds with the exception of the United States of
America, where 50 per cent. of such beds are unoccupied. In many
parts of London much difficulty has apparently been experienced
in finding Institutional accommodation for advanced cases of tuberculosis,
but in Battersea this difficulty has not been felt to any great