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where necessary) will be provided for the population as a whole (including
insured persons by Metropolitan Borough Councils, while treatment at
residential Institutions will be provided by the London County Council.
As regards treatment by General Practitioners, insured persons will,
upon termination of Sanatorium benefit, continue to be entitled to attendance
and treatment for Tuberculosis in their homes by insurance practitioners.
The provisions as to finance arising out of altered arrangements have
been set out in the circular letter (194) of the Ministry of Health, dnd have
been considered by the Council. Briefly, it may, however, be recalled that
in lieu of the contribution made by the Insurance Committee towards the
cost of Dispensary Schemes, which ceased on the termination of Sanatorium
benefit, a grant of an amount per annum equivalent to the amount received
by the local authority under its agreement with the Insurance Committee
will be available out of moneys provided by Parliament.
After deduction of this grant from the total expenditure on the Dispensary
Schemes of local authorities, half the remaining cost will be provided
by the Ministry of Health and half by the London County Council and
the Borough Councils.
The cost of the revised Dispensary Scheme of the Council for the
ensuing financial year is asked for by the London County Council to be
submitted for their approval, in time to be included in their Estimates, and
not later than the 30th November next.
In connection with the preparation of revised schemes, attention is
drawn by the London County Council to certain matters, as follows:—
1. Specialists facilities at hospital.—Copies of proposed agreements
entered into involving payment for such facilities should be
forwarded to the London County Council.
2. Expenditure ranking for the Council's grant will only be
admitted when provided for in the Estimates or approved in
principle before expenditure is incurred.
3. Expenditure under Public Health Act.—London County
Council grant towards cost of Tuberculosis Dispensary Scheme is
not available in respect of expenditure on : (i.) Sputum flasks for
personal use; (ii.) Printing notices and forms for Tuberculosis
regulations; (ii.) Time of Health Visitors, Nurses and other staff
employed in connection with duties covered by Tuberculosis regulations,
and expenditure on shelter and beds.
4. Discharged Soldiers and Sailors.—Cost of visits, etc., by
Healih Visitors recoverable from the Ministry of Health should
be shown as a credit in claims rendered by Borough Councils.
5. Staff.—Particulars should include name, qualifications, experience,
remuneration, duties and date of appointment, apportionment
of remuneration for part-time service, variation in staff and
rates of remuneration, etc.
6. Drugs, appliances, etc.—Dispensary accounts will be strictly
scrutinised, and excessive expenditure disallowed.
7. Charge to patients for dental work.—Provision should be
made for appropriate charges for dental work (including dentures)
other than fillings and extractions.
8. Extra nourishment.—Recoverable from Ministry of Health
when approved, and is not to rank for grant by London County
Council to Dispensary Schemes.
These matters have been kept in mind in the preparation of estimates
submitted with this Report.