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111
In all cases where patients are referred to the Dispensary, a report
is sent to the practitioner and, where necessary, arrangements are made
for treatment. 631 reports of this kind have been sent during the year.
Co-operation with Insurance practitioners continues under the scheme,
which has been explained in previous Reports, and close touch with
panel doctors has been maintained by means of the customary forms.
553 reports have been sent to, and 170 received from, panel doctors in
respect of patients having "domiciliary" treatment. 196 patients were
on ' 'domiciliary'' treatment on 31st December.
(v.) The arrangements for following up patients in cases where the diagnosis
is doubtful.
Cases in which a diagnosis cannot be arrived at after a reasonable
period of Dispensary observation, are referred to the London County
Council for admission to Brompton or Victoria Paik Hospitals for further
investigation. Cases of doubtful non-pulmonary tuberculosis are sent to
the London Hospital, as are also a few cases of suspected pulmonary
tuberculosis who are unable to accept offers of admission to hospital as
in-patients. In other doubtful cases, where admission to hospital is not
consideied necessary, arrangements are made foi the patient to attend the
Dispensary again after a lapse of a suitable period of time, so that the
case can be reconsidered.
(vi.) The arrangements for securing the examination and systematic
supervision of " home contacts."
A list of all contacts is prepared by the Health Visitor of the
district concerned, who arranges for their attendance at a convenient time
for examination and, where necessary, re-examination. All contacts of
school age are dealt with in co-operation with the School Medical Service.
363 contacts were examined, 194 being adults and the remainder children.
(vii.) Information as to special methods of diagnosis and treatment in use
and the number of persons to whom these special methods have been
applied.
The X-Ray ap paratus has continued in use for diagnostic purposes.
Cases of special difficulty have been referred to the London Hospital for
the opinion of their physicians. No special form of treatment has been
in use.