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35
Conferences have taken place between the various metropolitan
councils and the County Council, with the view of ascertaining how
co-operation may be best attained. One difficulty which has not yet
been solved is as to the manner in which payment should be made for
the use of the sanatoriums. There are two alternative methods, one by
which each borough pays for the number of non-insured patients sent
in, the other, that the cost should be paid by a general rate.
In the final Report of the Departmental Committee on Tuberculosis
it is pointed out that there is much need for research work in connection
with the social and economic causes of tuberculosis, and they specially
emphasize the importance of early diagnosis of the disease in children,
and the urgent need for a wide application of the principle of open-air
treatment and education in open-air schools. They also deem it of
importance that every effort should be made to secure that the food of
the country should be free from tubercle bacilli.
They submit a number of recommendations on methods of
prevention, similar to those in force in Westminster for some years.
While in no way desiring to minimise the importance of education and
supervision of consumptive patients, they are of opinion that in certain
cases it would be well to have compulsory isolation, particularly
where the patient's surroundings are such as to increase the risk of
other persons being infected.
Notification.—The total number of certificates received in the year
was 1,364; 511 were under the Poor Law Older, 637 under the
Hospitals Order, 170 under the General Order, and 46 under the
Council's Voluntary Scheme. Deducting 351 referable to other districts,
1,113 certificates were received in connection with Westminster cases.
The number of new cases of pulmonary disease was 473, of whom 105
were homeless persons or inmates of common lodging-houses, &c.,
and there were 27 new cases of other forms of tuberculosis. Three
notifications were received from school medical officers.

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