View report page

43
St. Pancras Tuberculosis Scheme.
The anti-tuberculosis work is divided between three authorities, viz:—the
Borough Council, which provides the tuberculosis dispensaries and whose
Medical Officer of Health receives the notifications of all cases of the disease
and is the administrative tuberculosis officer; the London County Council
which arranges (chiefly through other bodies) for the residential treatment of
uninsured persons; and the London Insurance Committee which arranges for
similar treatment for injured persons. The Metropolitan Asylums Board is
also an important authority in connection with the actual provision and
maintenance of institutions, and the Board of Guardians fulfil an important
function in the provision of beds in the Poor Law hospitals. The notified
cases are visited by the Horough Council staff, and all the work in
connection with the cases, including the search for, and examination of
contacts, rest with them until after the patient lias been examined
by the Tuberculosis Officer at the dispensary and recommended for
the institutional treatment. The treatment of the case then passes to a
large extent out of the hands of the Borough Council staff and the decision
as to the admission of the patient to an institution rests with the officers of
the London County Council and London Insurance Committee: The effect
of this division of work is that the initiative in regard to the direction and
extension of the direct campaign against tuberculosis, especially in connection
with the provision of institutions, is to a very great extent removed from the
Borough Council and its Medical Officer of Health. The latter officer's position
in relation to the selection of consumptive cases for institutional treatment, and
the following up of their after-history is most unsatisfactory, and his work in
this connection becomes largely controlled by the county authorities and therefore
from his point of view mechanical. This is not in the best interests of the
work. It should undoubtedly be performed by the officer who himself and
through his staff has an intimate local knowledge of public health conditions:
and this officer should be free to develop the work on his own lines, subject of
course to the kind of control which is exercised by the central authorities in
other public health work and which ought never to be such as to stifle
initiative.
Visiting Work.—The visiting work done during 1919 by the female visiting
staff at the Town Hall was as follows:—
Number of visits to homes of notified cases—
(a) First visits 949
(b) Subsequent visits 1839
Number of cases in which disinfection was carried out 70
Attendances of visitors at the dispensaries 33
Other visits made for various purposes 31
In consequence of additional work required in connection with the care of
tuberculous ex-service men and their families, Miss Parnell was appointed to
the work of visiting consumptive cases in addition to Miss Blaxland. Both
these ladies have also other duties in the department. Miss Bibby devoted a
good deal of her time to co-ordinating and advisory work in connection with
tuberculosis.