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and, therefore, this has been universally accepted by local authorities
throughout the country.
The salaries for nurses, I would suggest, should be £100 per annum
in order to attract the very best women that can be obtained, together with
amount for a uniform.
Finance.- The financial burden that will have to be borne by the
Council for the support of the dispensary is very small, for happily the
Government will come generously to their aid.
In a speech which the Chancellor of the Exchequer made to the County
Councils Association he said that " so far as insured persons were concerned,
it may be assumed that the authority running the scheme of institutional
treatment would receive the actual expenditure on the insured." Mr. Willis,
Assistant Secretaiy to the Local Government Board, in a Conference with
the Metropolitan Medical Officers of Health has said (and I quote from the
official report of the proceedings), " then there are the uninsured two-thirds of
the population. So far as they are concerned he (the Chancellor of the
Exchequer) is willing to pay half the cost if the local authorities will pay the
ether half. Therefore, for a full scheme two-thirds will be paid otherwise
than from the rates—a part from the Insurance Committee and a part from
the grant." This means that if a dispensary cost £2,000 per annum (an outside
amount) the Government and the Insurance Committee would pay
£1,333 and the Borough Council £667, or one-third of a farthing on the rates.
As regards the initial cost, that is, the capital cost, the same Assistant
Secretary said, " we (i.e., the Local Government Board) are willing to provide
four-fifths of the cost of establishing dispensaries." Therefore, if the cost be
£300, the Local Government Board would pay £240, leaving only £60 to be
borne by the Council.
These statements have since been confirmed in an interview at my office
by Dr. Chapman, one of the Medical Inspectors of the Local Government
Board, who called on me in the course of his inquiry as to the establishing of
tuberculosis dispensaries in the Metropolis.
Hence it will be seen that only a small proportion of the cost,
whether it be capital or for maintenance, will fall on the rates; and,
consequently, there can be no valid reason why the Council of this, the most
populous borough in the Metropolis, should hesitate to establish a dispensary
at the earliest moment possible on the score of expense.
In my opinion, a dispensary that is not run by the municipality would
have comparatively little success, because it would lack the prestige and
authority which institutions run by the public health authorities invariably