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At tlie Council's dispensary, the aim has always been that it should be
a means for the detection, diagnosis and prevention of the disease, and
not a place for curative treatment, except in cases requiring tuberculin
or some special form of treatment.
The Ministry ask that certain information be incorporated in the
Annual Report and specify 18 headings under which it is to be given. I
have referred these questions to Dr. Shinnie to reply. He reports as
follows :—
(i) Address of Dispensary; 1, Pimlico Road, S.W.
Staff:—Dr. A. J. Shinnie, Medical Officer.
Miss Sanders
Miss Alexander
Miss Walding
Miss Clark
Visitors.
Miss Price, Nurse and Clerk.
Dr. Braxton Hicks, Bacteriologist.
(ii) Applies to County Councils.
(iii) Co-operation with general and special hospitals, &c.—The Tuberculosis
Dispensary is affiliated by official agreement with Westminster
Hospital. By the terms of this agreement patients attending the dispensary
may be referred for the purpose of further diagnosis or for special
treatment. During 1920 36 cases were so referred. As regards diagnosis
of chest conditions it has not been found necessary to utilize the services
of the Westminster Hospital physicians mainly for the reason that there
are no beds available in the hospital for the purpose of observation of chest
cases. This need has been amply met by the Insurance Committee for
the insured of both sexes, including non-insured ex-soldiers, by the lease
of observation beds in Brompton and other chest hospitals.
As regards the diagnosis and treatment of other than chest conditions
the assistance rendered by the staff of Westminster Hospital cannot be
too highly praised. An increasing number of cases have been referred
to the throat and nose department, the orthopaedic, and skin departments.
The conditions for which patients have been referred have been
mostlythoseof a non-tuberculous nature occurring in tuberculous subjects,
e.g., enlarged tonsils and adenoids, nasal and laryngeal diseases, skin
diseases such as psoriasis, spinal conditions requiring massage and exercises,
&c. The department of remedial exercises under the direction of Mr.
RockCarling has been of great benefit to children of t uberculous tendencies,
e.g., with malformed chests. The charge of 2s. per attendance which the
hospital has lately had to enforce has unfortunately proved a drawback.
A few eases of surgical tuberculosis in children, e.g., hip disease and