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The Tuberculosis Dispensary at 108, Grange Road, carries out
most of these duties, but there are certain directions in which
improvement will be necessary if the scheme is to fulfil modern
requirements. In the first place, there is not a close enough connection
between the Dispensary and the Public Health Department,
and to make any improvement it will be necessary for the
Council to consider the question of taking over the Dispensary,
and making it a branch of the Public Health Department. I
think this is most essential, since the real work of the Council in
the matter of Tuberculosis is preventive, and this cannot be done
effectually unless the whole of the activities of the Council in this
direction are brought under one Department.
As regards the examination of contacts, this is not carried
out as systematically and as thoroughly as it should be. Only
353 were examined in 1919, and if the estimate of 2,000, at the
very low rate of 4 contacts to every notified case, is correct, the
percentage of these who have been examined is only about 15.
The arrangements for diagnosis are not complete, since there
Is no X-ray apparatus, an appliance absolutely necessary for
modern work. Some definite arrangement should also be made
with Guy's Hospital for applying special diagnostic methods in
certain cases. Further, there is no provision for the treatment
of dental cases at the Dispensary.
At the present time there is too much attention paid to the
purely clinical side of Tuberculosis as distinct from the preventive
side, and there is a tendency for Dispensaries to become simply
kinds of Out-patients' Departments of general hospitals, where
people come to receive bottles of mixture for coughs, dyspepsia,
etc. If the time spent in prescribing cough mixtures and things
of that kind were spent in visiting and examining contacts, the
Dispensary would serve a much more useful purpose.
The present staff consists of a Tuberculosis Officer and Assistant
Tuberculosis Officer, two nurses, one dispenser, one secretary,
and one caretaker.