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58
only seven children have been sent away under it
during 1927.
In concluding my remarks under this heading, I
should like to refer to the great help which we receive
from the local branch of the Invalid Children's Aid
Association in dealing with children who, while not
actually tuberculous, are debilitated as a result of
acute or chronic illnesses and who are, therefore, liable
to succumb to attacks by the tubercle bacillus or other
organism. Many children in this category who come
up to the Dispensary for examination are living under
conditions prejudicial to their complete recovery, and
often in actual contact with open cases of tuberculosis,
and it is by getting these away for periods of convalescence
in the country or at the seaside that the
Association does such pre-eminently useful service.
Co-ordination between local Practitioners and. Tuberculosis
Officers.—At the present time the question of
the attitude of the private practitioner towards the
Public Health services is one which is the subject of
some controversy both in the medical and lay press.
It is obvious that if institutions, such as Tuberculosis
dispensaries, are to be regarded as being in competition
with medical men in general practice little progress
can be made in any anti-tuberculosis work. The possibility
of friction has always been uppermost in the
minds of the Medical Staff in this Borough, and it
may be of interest to point out here that every possible
step is taken to safeguard the rights of doctors
with whom we come in contact. For instance, no
person is taken on to the Dispensary books if he is
under medical care unless he produces definite evidence
that his doctor is desirous that he should be examined,
while in cases referred for an opinion a very special
rule is observed that the Tuberculosis Officers invariably
report straight to the doctor and make no verbal communication
to the patient beyond that necessary to
allay his immediate anxiety. As a report is always
sent to the doctor concerned within a very short period,
the patients do not suffer, and indeed when the position
is explained to them we never find that they fail to