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these have been given, the council pay an additional fee of ten shillings, subject to the limitation of
liability indicated under heading (l) above.
The council, by means of the usual health propaganda channels, have brought to the notice of
Kensington residents the fact that diphtheria can be prevented, and have urged those who desire
security for their children to apply to their family doctor.
After the council had adopted the scheme outlined above, doctors in the borough were invited
to join the immunisation panel; and 64 names now appear thereon. The scheme was put into
operation on the 1st May, 1934, and has proved very successful. In the early days it was found
that a number of children sent for the preliminary Schick test gave a negative result and therefore
did not need to be immunised, with the result that the doctors who sent them did not receive any
fee. If the doctors had not gone to the trouble of persuading the parents to take their children
to the Schick testing clinic, but had immediately undertaken immunisation, they would have
received a fee of ten shillings for each child. It is desirable that, as far as possible, children over
five years of age should be Schick tested before immunisation, and that doctors should be induced
to encourage parents to take their children to the clinic for this test. It appeared, however, that the
more successful doctors were in their persuasive efforts, the fewer were the cases in which they could
receive fees ; to meet this difficulty, the council on the 26th June, 1934, resolved that a fee of
2s. 6d. should be paid to a doctor in respect of each child sent by him to the clinic for a
pre-immunisation Schick test if it proved to be negative.
Towards the end of the year a few cases came to notice where a doctor had given one or two
injections and, for some reason beyond his control, found it impossible to give the remainder. It
seems unfortunate that a doctor should be out of pocket to the extent of several shillings as a result
of his efforts to co-operate with the council in this branch of preventive medicine, but the council
took the view in the early days that it is undesirable that there should be in the community a number
of partially immunised children who might develop diphtheria and thus bring discredit on the
scheme. For this reason the council decided that they would pay only when the three doses had
been given. Nevertheless, at the end of the year they recognised the hardship caused to individual
doctors, and they decided that if a doctor is unable to complete the treatment of a patient
through circumstances beyond his control they would defray the cost of the immunising material
already used by him.

Judging by the difficulty experienced in persuading the public to accept diphtheria immunisation
for their children in many other areas of this country, it was contemplated that not more than 500
children would be immunised in Kensington in the first twelve months. As 842 were immunised
during the eight months of 1934 that the scheme was in operation, the result must be considered
satisfactory. The doctors in the borough are co-operating enthusiastically with the council in
this scheme which is a pioneer one of its kind. At the time of writing (April, 1935), the total
number of children immunised has reached well over 1,600, and similar schemes are now being
introduced in other areas.