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47
in the case of a voluntary dispensary the rules which the Board may find
it necessary to make are carried out and the work is done in co-operation
with the London County Council and the Borough Council; that arrangements
are made to include any voluntary dispensary in the scheme of
the Borough Council, in which case an agreement should be entered into
with the authorities of the dispensary indicating the nature and extent
of the services which they will provide, and specifying the amount of the
payment the Borough Council will make to them; and a draft of any
such agreement should be submitted to the Local Government Board
and their approval obtained before the agreement is executed. A copy
of the draft agreement should also be sent to the London County Council
when it is submitted to the Local Government Board.
The voluntary dispensary should be affiliated to a general hospital
or hospital for consumption to which specially difficult cases would be
referred for diagnosis or treatment.
Beds should be available for watching cases and determining the
form of treatment best adapted to the patients' needs. The Board consider
that these beds should be provided not at the dispensary but by
the London County Council.
It is essential that arrangements should be made for the complete
co-ordination of the work of the dispensary with the preventive work of
the Borough Council and their officers under the Tuberculosis Regulations,
1912. The circular letter defines in detail the manner in which
the co-ordinating work of the dispensary and the public health department
should be carried out.
In regard to finance, it appears to the Board that where the scheme
of the Borough Council includes any voluntary dispensary it is desirable
that the contributions of the Borough Council towards the expenses of
the dispensary should be made in respect of the whole of the population
of the borough, and that the payments of the London Insurance Committee
for the dispensary treatment of insured persons should be made
to the Borough Council. The Government Grant towards the annual
cost of the scheme is limited to 50 per cent. of the amount chargeable to
the rates, and no portion of the grant will be payable direct to the voluntary
institutions.
The Borough Council is to be regarded as the providing authority
for dispensaries, although the dispensary which serves the Borough is a
voluntary organisation, and the dispensary is to serve the whole of the
community, including insured persons.