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49
Insurance Committee in respect of these applicants. In
several instances much hardship resulted from the new
arrangement. Persons for whom domiciliary treatment had
already been arranged, were advised that if the doctor attending
was not already on the panel such treatment must cease, and
application would have to be made to a doctor whose name
appeared on the panel. If the patient was so unfortunate as
not to have made the necessary arrangements by the specified
date, it was possible that he would be unsuccessful in his
application to a panel doctor for treatment.
The temporary Local Sub-Committees had only a short
existence and recently a new District Committee has been
formed. As far as one can see, this Committee will possess no
executive, administrative, or discretionary powers whatever,
and the London Insurance Committee will continue to retain
the supreme control.
In my opinion it is very desirable that all applications
for sanatorium benefit should be considered, primarily, by
the Local Committee. This Conimittee should have power,
on the advice of the Local Consultive Tuberculosis Officer,
to immediately arrange for domiciliary or dispensary treatment,
and, when treatment in a Hospital or Sanatorium was
necessary, to arrange for the same through the County
Committee. It cannot be disputed that much time would be
saved, and greater efficiency effected, if all applicants were
examined by the Local Tuberculosis Officer, instead of, as at
present, the applicant having to attend before the Expert
of the County Committee in London. An arrangement of
this description would enable the Local Committee to get into
closer touch with the patient than is possible with the County
Committee, and to become conversant with the environment
and particular needs of the patient.