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Certain changes in the staffing of the Dispensary were made and the Council's Women
Health Officers took over the home visiting and reporting previously done by the Dispensary
Nurses of the Voluntary Committee. The Women Health Officers, including the members of the
internal staff, have loyally supported the Dispensary, and with the Tuberculosis Officer, have to a
great extent been responsible for promoting the efficiency which has been secured.

The total number of new cases shows a decline on last year, thus continuing the satisfactory
diminution generally noticed and referred to in my Annual Report for 1921. It seems justifiable to
believe that the fall is associated with the sustained work not only of the Dispensary but also of
the medical profession generally, and to the vigorous action of public bodies.
The cases went to the Dispensary either on their own account or through the following
agencies:—the Public Health Department of the Council, the Guardians, the Ministry of Pensions,
the London County Council, Hospitals, School Medical Officers, School Care Committees,
the Kensington Dispensary and Children's Hospital, the Invalid Children's Aid Association, the
Kensington Council of Social Service, the Infant Welfare Centres, and private practitioners. The
large number (128) sent up by private doctors is encouraging, as it is the aim of the Dispensary
staff to obtain the support and co-operation of the medical men in the district in all matters
relating to tuberculosis.
The treatment recommended for the 139 definite cases of tuberculosis was as follows:—
Dispensary 49, Sanatorium 44, Hospital 13, Domiciliary 18, the Infirmary 7, transferred to other
public authorities 2. In 6, no special treatment was found necessary.
The total number of attendances at the Dispensary during the year was 3,951 and the number
of systematic physical examinations made was 1,575.
Home visits made by the Tuberculosis Officer were 110, and by the Women Health Officers
2,396. The latter does not represent a full years visiting by the Health Officers as they did not
begin this work till the month of February.
Written reports on patients to public authorities number 1,020 and to private practitioners
209. The former figure is a marked increase on the total for 1921, and the latter is an encouraging
rise of 13 per cent.
The sputum examinations totalled 552, being 42 more than in 1921. They referred to 425
individual patients in attendance during the year, and of these 119 or 28 per cent. showed tubercle
bacilli in the sputum, while in the remaining 306 cases or 72 per cent. no tubercle bacilli were
found to be present.
Besides routine examinations of old and new cases and the making of recommendations for
treatment either at the Dispensary or elsewhere, special efforts have been made to secure the
examination of "contacts" of notified cases, and included in the number of new cases seen are 183
of these. Other "contacts" are examined by their own doctors and also by the School Medical
Officers, but many escape and it is hoped to secure a larger number of "contact" examinations of
cases notified, both by the Dispensary and outside, through a tightening up of the arrangements at
present in force. The actual number of "contacts" found to be definitely infected is relatively
small, but it is nevertheless of the utmost importance that these few should be discovered. Further,
the fact that other cases have been to the Dispensary spreads the knowledge of its existence and
purpose and probably increases the readiness of these "contacts" or their friends to make use of it
again in the event of suspicious symptoms arising later. There is evidence to show that this does
occur by subsequent requests for re-examination in some cases.
"Suspect" cases, whether "contacts" or otherwise, are being more actively pursued, and in
order to lessen their tendency to cease attendance before a final decision has been made, it has been
thought desirable in some cases to put them temporarily on treatment at the Dispensary, thereby
promoting their regular attendance, with the consequently increased opportunity of completing the
diagnosis. This procedure, to a certain extent, contravenes the principle aimed at by the London