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either insured persons or can afford to pay for medical attendance, should not
be encouraged to attend the dispensary for routine treatment."
This question was brought before the Dispensary Committee, who directed
the Tuberculosis Officer to carry out these instructions, but at the same time
the Committee communicated with the Ministry of Health, pointing out that
in their opinion it was desirable that all cases of Tuberculosis, excepting
those receiving institutional treatment, or those who are too ill to attend, should
be treated at the Dispensary. Great difficulty has been experienced in getting
patients to attend the Dispensary for the purpose of supervision only, the
Tuberculosis Officer losing touch with them, whereas they would attend quite
regularly for treatment. The panel patient also points out that he is being
penalised by the fact that he is insured, because if he were uninsured he could
obtain treatment at the Dispensary if he so desired.
In spite of the reduction in the total number of attendances the general work
of the department has increased in amount. The total number of systematic
examinations has increased from 3,894 to 4,123,* the number of letters and
reports from 3,324 to 3,567,* and the number of visits to patients at their
own homes from 126 to 200.*
The local practitioners continue to make every use of the Dispensary as a
centre for the diagnosis of doubtful or difficult cases, and it is satisfactory to
note that the number of new cases from this source remains high as compared
with those of other boroughs.
In conclusion, I should like to thank the Dispensary Committees, the Medical
Officers of Health, the Hospital Physicians and Surgeons, and the Hospital
Secretary, for their help and advice, and also the Dispensers, the Clerk, the
Nurse, and the Porter, all of whom have done their work very efficiently.
( Signed) H. TYLFORD HOWELL
March 1st, 1922.
* Including Bethnal Green and Hackney cases.