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43
The Departmental Committee made the suggestion that each
area should have a Chief Clinical Tuberculosis Officer who should
also act as Medical Adviser to the Insurance Committee of that
area, and the Board would suggest that the London County Council
should carefully consider whether this arrangement might not be
carried out in the case of London. This Officer might also, in
consultation with the other medical men concerned, supervise and
generally direct the selection of cases to receive residential
treatment.
As regards the financial arrangements to be made, the Board
would remind the County Council that they have already invited
their observations on this question, and particularly on the point
whether the arrangements with the Insurance Committee for
Dispensary treatment under the Insurance Act should be made
by the County Council or by the various Borough Councils, and
whether the expenditure should be locally or centrally defrayed.
It seems to the Board to be desirable that the cost of the scheme
should, at any rate to a large extent, be borne by London as
a whole. Inasmuch, however, as the Dispensaries are to be
provided locally, some proportion of the cost of providing these
institutions should be charged locally.
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It would simplify matters if, as regards the treatment of
insured persons, the County Council were recognised as the providing
authority for all the institutional treatment required,
whether in Dispensaries or other institutions, so that the London
Insurance Committee could make one agreement with the London
County Council in regard to all the services rendered to insured
persons.
Although Dispensaries are to be provided locally, it would
seem to be practicable to regard the London County Council, for
the purpose of such agreement, as the one providing Authority,
if they were to make supplementary agreements with the other
Authorities for the provision of dispensary services. Such supplementary
agreements would afford a means by which the charge
for dispensary services might be to some extent equalised as regards
the Metropolis, and they would also facilitate the arrangements
for securing uniform working.
The Board direct me to add that they would be happy to
arrange for a further conference with representatives of the County
Council if it should be considered that this would facilitate the
formulation of a general scheme for the Metropolis.