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79
out last year, many of those contacts who dislike attending the
Dispensary are examined privately by their own doctor who would
refer the case for closer investigation if any doubts were felt. In
this way some "new cases" are examined who are really contacts.
Only those attending as a direct result of the nurse's visit are counted
as "contacts."
Residential Treatment.—The London County Council issued
a revised scheme for treatment of tuberculosis during the year.
The scheme includes provision for the issue of travelling expenses
to necessitous patients accepted for admission to the Council's
institutions.
It also provides for the issue of travelling expenses in necessitous
cases where a relative was obliged to visit a patient in an emergency
upon the request of a Medical Officer of a Sanatorium.
Hospital Visits.—The Tuberculosis Officer has paid visits
regularly to St. Alfege's Hospital during the year. This is considered
very helpful, as it means patients have continuous supervision.
Many doubtful cases have been seen in consultation
with the resident Medical Staff, and such consultations as in the
case of those under treatment, are beneficial to the Tuberculosis
Officer and the Medical Officer connected with the cases.
X-Ray Examinations.—The arrangements made with the
London County Council relative to the carrying out of X-Ray
work at St. Alfege's Hospital, continue to give satisfaction. There
were 554 examinations carried out in 1936, as compared with 533
in the previous year.
In April 1936, the London County Council agreed to make
no charge for screen examinations when the Tuberculosis Officer
carries out the work, and to apply a flat rate of 2/6 for skiagrams.
At all times, every facility has been afforded and the smoothness
of the routine generally is a matter for gratification. The
only possible drawback is structural. It is felt that dressing room
facilities are inadequate but it is thought that this point may
receive attention.
Artificial Pneumothorax Refills.—The agreement reached
in 1934 with the London County Council regarding the provision of
this continuation treatment at St. Alfege's Hospital has proved
satisfactory. It means that patients can be attended to at one
centre instead of various hospitals at a distance. The cost is
reduced to half when the Tuberculosis Officer carries out the work
and approximately 200 refills have been given in connection with
the Dispensary during 1936.