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The decreased number is largely due the fact that it was endeavoured
to limit treatment at the Dispensary to those requiring special treatment
such as Tubercnlin, aspirations, etc., and to those who could not obtain
other adequate medical attendance elsewhere, so that where insured
patients could obtain suitable treatment from their own panel practitioners,
they were put on domiciliary treatment. It was also
endeavoured in doubtful cases to limit to two months the period of
observation at the Dispensary before a definite diagnosis was arrived
at. The increased number of sessions started at the end of 1920 have
aided in this by allowing more frequent and detailed examinations.
Special appointments are made for the occasional individual who
cannot attend during dispensary hours.
Of those attending, 709 were new cases, 231 being insured.
This number includes 156 contacts. This is not a satisfactory number
of contacts, but from personal experience of visiting at the houses
of patients, I am aware of the difficulty of persuading parents to
bring contact children for examination or of persuading themselves or
other adult contacts to be examined. It has been suggested that while
excessive interference with the liberty of the subject is to be deprecated,
this matter is so important that it seems quite permissible to insist that
after a death from tuberculosis, or after a notification, the head of the
household should furnish the Medical Officer of Health with a certificate
stating that all the contacts have been seen by a qualified medical man
and undergone a proper examination, and detailing the results thereof.
Such certificate would of course be provided free at the Dispensary,
and in this way the majority of contacts in any area would come within
the purview of the Tuberculosis Officer.
In last year's report was mentioned the intention of asking the
Council's sanction for the appointment of a part-time nurse to assist in
the work. This sanction was obtained and the services of a part-time
nurse were secured in March for four mornings a week at the Dispensary,
thus giving the whole-time nurse considerably more time for visiting
work. The result is seen in the increased number of visits.
Visiting at the homes of all notified cases has for some time been
carried out by the Dispensary whole-time nurse. Formerly a lot of
this visiting was done by the Health Visitors on the staff of the Public
Health Department. If this procedure were again adopted it would
give the Dispensary nurse further opportunity for the necessary visiting
and re-visiting at the homes of dispensary cases