London's Pulse: Medical Officer of Health reports 1848-1972

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London County Council 1920

Annual report of the Council, 1920. Vol. III. Public Health

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38
strated to be successful and (ii.) improved facilities for diagnosis. The first defect, it is hoped, will be
overcome by the provision, to be made in connection with the dispensary service for searching out and
examining contacts, and, the second, partly by greater use of the out-patient facilities available at
hospitals to be used as consulting centres, and partly by the provision in these institutions of a number
of observation beds to which patients will be sent for short periods and thence drafted to institutions
suitable to their condition. Negotiations with regard to the latter proposal were in progress at the end
of the year.
Dealing now with the accommodation in residential institutions provided, and the results obtained
during 1920, the Council continued its policy of utilising accommodation available through the Metropolitan
Asylums Board supplemented according to necessity by beds in voluntary institutions.
The Council completed its agreement with the London Insurance Committee under which the
Council had assumed responsibility for seeing that adequate accommodation was provided for insured
and uninsured persons, including special provision for ex-service patients, and for meeting any
deficiency in the cost involved in treating insured persons after the London Insurance Committee
had exhausted the whole of the money available for the purpose under the National Insurance Acts.

At the beginning of the year it was estimated that accommodation would be required as follows:-

(a) Insured persons750
(6) Ex-service patients500
(c) Uninsured adults375
(d) Children625

At the end of 1919, the accommodation amounted to 105 beds for uninsured adults, and 258 beds
for children in institutions belonging to the Metropolitan Asylums Board, and 94 beds for uninsured adults
and 306 for children, in voluntary institutions. Diving the year 1920 there were further extensions of
accommodation provided by the Metropolitan Asylums Board, particularly beds for advanced cases in
men, and for children. This increase was, however, in some degree counter-balanced by the reversion
to their normal purpose of certain fever hospitals which were used for ex-service advanced cases, with the
result that the accommodation for civilian men in the advanced stage has been seriously reduced. The
accommodation available through the Metropolitan Asylums Board on 31st December, 1920, was 197
beds for uninsured adults and 426 beds for children.
In the case of adults, practically the same accommodation has been required in voluntary institutions
owing to increased numbers dealt with. There has been a slight reduction in the number of beds
necessary in voluntary institutions for children, although this reduction has been less than the additional
Metropolitan Asylums Board accommodation owing to the increased number of children requiring treatment,
attributable in part to the increasing difficulty experienced by charitable agencies of the type of
the Invalid Children's Aid Association in meeting the increased charges due to the present high cost of
maintenance.

The total number of beds in use on 31st December, 1920, was as follows:—

Adults.Children.Total.
Insured.Ex-service.Uninsured.
Metropolitan Asylums Board institutions2122721974261,107
Voluntary4993451092781,231
Total7116173067042,338

The Council continued the scheme of co-operation with the Invalid Children's Aid Association
under which, in return for a grant, the Association provided convalescent treatment for children, and also
assisted in the provision of surgical appliances for children who had received treatment in residential
institutions under the tuberculosis scheme. The sum allowed during the year for this service was
£1,350.
The following extract from the annual report of the Invalid Children's Aid Association indicates
the work accomplished with this financial assistance:—
"The scheme of co-operation between the L.C.C. and the I.C.A.A. for the treatment of tuberculous
children, which has been in operation for the last five years, has again been carried on through
another year with, we venture to hope, successful results. Owing to the greatly increased cost of Homes
the council agreed in July last to raise their grant on each case to two-thirds of the balance of cost, after
deducting parents' payments, with a maximum of 7s. 6d. This has been a great help to the I.C.A.A.
As,"heretofore, the Council has in most instances provided treatment for the more serious cases of tuberculosis,
and all cases of pulmonary tuberculosis—referring them on in many cases to the I.C.A.A. for
convalescence when discharged from sanatoria. The Tuberculosis Sub-committee has met every month,
and 368 children were sanctioned for convalescent treatment with help from the Council's grant, and
26 surgical appliances were provided—116 of these children are still away in 1921. This Committee also
considered 23 cases which were found to be ineligible for the Grant-in-Aid, but whose requirements were
subsequently supplied by the I C.A.A. In addition to the above, many tuberculous children were sent
away, the cost being met by the parents' payments so that no help was required from the Grant-in-Aid."
Co-operation
with Invalid
Children's
Association
for convalescent
treatment