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14
TUBERCULOSIS.
It will be noted that the 2,920 certificates are 306 in excess of the new cases reported in
the five years. Actually they dealt with only 851 new cases, the balance referring to cases
included among the " survivors " at the end of 1913—1,777 " definites " and 1,002 " suspects"—
as well as those coming to light during 1914-18. A further complication involved arises
from the fact that reports relating to the same patient have been received from two or more
institutions. A special analysis of certificates from institutions has been established recently
from which it is hoped to extract better information as to the numbers of cases receiving
treatment in institutions. Even after admitting the defects of the foregoing analysis, it
cannot be regarded as satisfactory that so large a proportion of cases should have been
reported from Poor Law Institutions, having regard to the scheme for sanatorium treatment
inaugurated under the National Insurance Act and that provided by the County Council.
Insured Persons.—During the five years 499 applications for " Sanatorium Benefit
passed through the Department—335 from males and 1154 from females. The total number
of applications received each year was—1914, 113; 1915, 111; 1916, 102; 1917,87; 1918,
86. Of the applications received 97 (19'4 per cent.) were not completed owing to
Ineligibility of applicant 8 Removal from Borough 5
Death of applicant 28 Withdrawal of application 56—
a not very satisfactory record. The 402 grants of benefit took the form of
Admission to Sanatoria 298.
„ „ Hospital 45
Domiciliary Treatment 45
Dispensary „ 14
The 298 admissions to Sanatoria included 157 to" Downs" and 95 to " Winchmore Hill."
During the whole period 25 patients (7*2 per cent.) died while receiving residential institutional
treatment.
Uninsured Persons.—The applications for treatment under the County Council's scheme
numbered 216—115 for adults (males 21, females, 94) and 101 for children under 16 vears of
age. The annual numbers of application were—1914, 13; 1915, 57; 1916, 74; 1917-42;
1918, 29. Forty-two (42) applications (19*4 per cent, of the total) were withdrawn, and 3
others not completed owing to removal from the Borough (2 cases) and death (1 case). The
171 completed applications resulted in
Admission to Sanatoria 90 cases.
„ „ Hospital 81 „
Only one death occurred among the patients while under residential institutional treatment.
Dispensary Work.—The Paddington Dispensary for the Prevention of Consumption was
opened as a voluntary institution in 1909. It worked in close co-operation with the Public
Health Department until 1914, when "Dispensary Treatment " became an integral part of
the Tuberculosis Scheme, formulated in that year by the County Council to provide treatment
for the tuberculous uninsured population—for the insured, provision already existed under
the National Health Insurance Act, 1911. An agreement* was made between the Council and
the Executive Committee of the Dispensary under which the Council became largely, but by
no means entirely, responsible for the maintenance of the Dispensary, so far as its expenditure
related to uninsured persons. In 1915 a second j Dispensary was opened in connection with
St. Mary's Hospital which begun work for the County Council's scheme in March, 1916, the
Borough being divided into two " Tuberculosis Areas."
In 1915 the staff of the Talbot Road Dispensary comprised 2 Tuberculosis Officers, 2
Nurses (one whole time and one part time), and I Dispenser. In 1918 the staff was—1
Tuberculosis Officer (whole time), 4 Nurses (3 whole time and 1 part time), 1 Dispenser (part
time) and 1 Secretary. The Staff of St. Mary's Dispensary consists of I Tuberculosis Officer
and 1 Nurse, but that Dispensary has the advantage of the services of all members of the
Hospital Staff. An Executive Committee is in charge of each Dispensary, to which the
Council appoints representatives with .the Medical Officer of Health as an ex-officio member.
* The date of the first agreements—which are annual ones—was. October 11th, 1916, but the dates on which
the Dispensaries commenced the work under the scheme were - Talbot Road, July 28th, 1914, and St. Mary's,
March 1st, 1915.
t For convenience, the two Dispensaries will be referred to as " Talbot Road " and " St. Mary's."