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LADY ALMONER.
A separate short section of the Report was devoted last year
for the first time to the work of the Lady Almoner, and I find
that a number of Councillors are under a slight misapprehension
as to the nature of her work, believing it to consist almost entirely
in the collection of money. Primarily, her work is in connection
with tuberculosis, and as a part of the Tuberculosis Scheme; she
does collect money in the form of the contributions of patients
towards the cost of sanatorium treatment. The amount which a
patient is required to pay is assessed according to ability to pay
and the assessment is made by Miss Pike and approved or revised
by the London County Council. The amount approved by the
London County Council is then collected, in most cases in weekly
instalments: —
Number of cases assessed 223
Total sum collected £416 5s. 6d.
The sum collected is small and in no way represents the cost
of treatment, but the principle that the patient should pay
something towards the cost of treatment is one which has been
adopted by the London County Council, and it therefore forms
a definite part of the Tuberculosis Scheme. I do not dissent from
this principle so far as certain services are concerned, but I personally
consider that its application in the case of tuberculosis is
unfortunate for two reasons. Tuberculosis is a disease of poverty,
promoted by poverty and only too frequently leading to poverty.
The poor financial resources of most of our patients are ill able
to stand the strain of even a small assessment, especially when
the payments have to be kept up over a comparatively long
period. The amount collected from those who are in a somewhat
better financial position is so small as to render collection only
worth while as an object lesson in self-help, and this I imagine,
is the idea underlying insistence on this form of contribution
There is a second objection, however, which I regard as being of
greater importance. The removal of a patient to sanatorium
certainly benefits the patient, but it also removes a source of
infection from the home. In this latter aspect the removal of a