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pensary, the writing of letters and of reports; attendance at the
I.T.C.C., the examination of sputum and home visiting.
Very little time is available for consulting with the practitioners
of the neighbourhood about their own cases, and so far no time has
been found for having consultation with the Tuberculosis Physician
of Guy's Hospital. If the centre at Guy's Hospital is to be of use,
a certain amount of time ought to be available for this purpose each
week.
A number of children recommended for Sanatorium treatment
have been sent by the London County Council to Great Ormond
Street Hospital, and returned therefrom as not suffering from active
Tuberculosis. Experience, however, has shown that it is most
desirable to keep these cases under observation, as a considerable
number of them, though not suffering from active Tuberculosis at
the time of their examination at the hospital, subsequently develop
active symptoms, and it then becomes necessary to make some
provision for their treatment, as they are not sent to Sanatoria, and
cannot be sent to ordinary convalescent homes. In these cases it is
very desirable, therefore, that the Tuberculosis Officer should be
able to consult the physicians in charge of the cases at the special
hospitals.
If a part-time Medical Officer were employed, his time would be
fully taken up in attending the ordinary examining sessions, and the
contact session on Saturday morning. As time is insufficient during
an examining session to allow of reports to Public Authorities being
written at the time of examination, his work would be confined to
the treatment and re-examination of old cases, and the examination
of contacts on Saturday mornings. All reports to Public Authorities
on these cases, as well as his own, would have to be written by the
whole-time Medical Officer, and this would further reduce the time
available for home visitations, the examination of sputum, and consultation
with the part-time man over difficult cases.
The next point to consider is the cost of the part-time Assistant
and the nature of his engagement. If this were a guinea and a half
per session of two hours, the cost would work out at about £500 per