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49
This table indicates that the increase in the total compared with
1927 is due largely to an increase in cases referred by the School Medical
Officer and in cases seen in connection with St. Stephen's Hospital. The
slight decrease in the number of patients referred by practitioners is
explained by the fact that the total number of notifications in Westminster
in 1928 was slightly lower than in the previous year.
The cases referred by the Ministry of Pensions were for the most part
old cases who had moved into Westminster from elsewhere. As pointed
out last year, a gradual decrease in the number of pensioners attending
is to be expected.
Reference has been made in previous reports to the importance of
the connection between the Dispensary and St. Stephen's Hospital.
These cases are almost all definite cases of tuberculosis, so about a quarter
of the new cases of tuberculosis, as distinct from suspects, are obtained
through the hospital. Many of these new cases are from Common Lodging
Houses and have often been resident in Westminster only a short time.
Others, however, are genuine Westminster residents of the type who,
from choice or necessity, do not seek treatment until they are too ill
to carry on. These are sent straight to St. Stephen's Hospital by medical
practitioners, and many of them would never come in touch with the
Tuberculosis Officer except through the hospital. It is possible to arrange
for suitable cases to be transferred to the London County Council institutions
and to get others to attend the Dispensary after discharge from
St. Stephen's Hospital. Considerable use is made of the Hospital for
Dispensary cases who are awaiting a Sanatorium vacancy, and who
cannot be treated at home, and for other more advanced cases where
it is desired to see if sufficient improvement is made under hospital conditions
before recommendations are made to the County Council.
Even more important is the touch which can be maintained with
old Dispensary cases. Many advanced cases which would not be considered
eligible for treatment under the London County Council's Tuberculosis
Scheme, are recommended from the Dispensary to St. Stephen's
Hospital. Some of these are patients who have attended the Dispensary
for many years and who are more willing to enter the hospital when they
know that they will still be seen by the Tuberculosis Officer. In other
cases, the Tuberculosis Officer finds cases in the hospital whose Dispensary
attendance has lapsed.
It would therefore seem that the connection between the Dispensary
and the hospital docs much to aid continuity of treatment, which is of
prime importance in the treatment of Tuberculosis. It is highly desirable