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the poor law medical officer. It is significant that, one of these, the
Royal Provident Dispensary, Pimlico, closed down sonic years ago owing
to lack of support, and the building has since been demolished.
It has often been said that the general medical practitioner is first line
of defence in the constant warfare against disease which is being waged
in every civilized community. These dispensaries are staffed by general
practitioners in the neighbourhood who, in addition to the advantage of
having intimate knowledge of the medical histories of the families,
have also almost daily contact with the home conditions, a factor which
can be appreciated at its true value by those whose duty it is to supervise
the public health.
In any scheme of co-ordinated health services, the fullest recognition
should be paid to the work of these institutions. It is possible that the
London County Council may, in accordance with the Local Government
Act, 1929, co-ordinate the work of the voluntary hospitals with that of
what were formerly the poor law infirmaries. This would give a valuable
opportunity of linking up the out-patient work of the hospitals with
the medical treatment carried on by the dispensaries in the homes of
patients. It might also provide what at the present time is lacking in
the teaching schools of the London hospitals, namely, training in
diagnosis and treatment in the homes of the people, which is probably the
most important work which a general practitioner is called upon to do.
National Health Insurance.
Under the National Health Insurance scheme there are 90 medical
practitioners practising in Westminster who are under contract to treat
patients in insured occupations.
The City of Westminster Guardians.
The City of Westminster Guardians, in addition to providing hospital
accommodation to the number of 720 beds at St. Stephen's Hospital
and beds in convalescent homes, have a staff of 6 part-time medical
officers whose duty it is to attend daily at the Guardians' dispensaries
to deal with out-patients and also to undertake treatment at home for
cases referred by the Relieving Officer. Until 1st April, 1930, the
Guardians are also the authority for administering the Vaccination Acts.
The Guardians provide free vaccination and re-vaccination for persons
permanently resident in the City. There are five public vaccinators
working in different areas. The Vaccination Officer, also on the Guardians'
staff, acts as registrar for the purposes of the Vaccination Acts.
The City Council is an authority under the Maternity and Child
Welfare Act, 1918, and has established a scheme which, in conjunction