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64
Close co-operation lias been maintained with the local authorities. Frequent
consultations take place between the Tuberculosis Officer and the Medical Officer
of Health for the Borough, and at the end of the month, the latter is furnished
by the former with reports of the work done in the Dispensary. Numerous reports
and returns have also been prepared for the London County Council and other
authorities.
Many of the children seen at the Dispensary have been sent by the Medical
Officers of School Clinics and Child Welfare Centres for further opinion. On the
other hand use has been made of the arrangements whereby the School Medical
Service keep under observation children referred to them either as unexamined
contacts (vide infra) or as being in an unsatisfactory state of health.
Close co-operation has also been maintained both with the local medical
practitioners and with the Hospital; and it is from these sources that the majority
of patients have come. Full advantage has been taken of the valuable facilities
offered by the Hospital for the diagnosis of obscure cases, particularly in the
matter of X-Ray work, Laryngoscopy, and Pathological investigations. It is also
a great help to have at hand an Institution to which tuberculous patients can be
referred for treatment of non-tuberculous ailments to which they may be subject,
the treatment of which adds so much to their welfare. The Dispensary is also
used by the Hospital as a channel for furnishing the various reports sent to the
County Councils concerning In-patients who come under their Schemes for the
Institutional Treatment of Tuberculosis.
Patients referred to the Dispensary from the Out-Patient Department of the
Hospital are put in touch with the Tuberculosis Officer of their District and
arrangements for their removal to Sanatoria, etc., thus facilitated.
Special mention must be made of the help given by the Tuberculosis Care
Committee, and the organisation which it represents, in the amelioration of home
conditions and in assisting the families of those who have gone to Sanatoria, and
in other matters, which, though not strictly medical, are of the greatest importance
in treatment.
All patients attending the Dispensary are visited periodically by the Dispensary
Nurse and reports made.
Every effort has been made, through the agency of the Dispensary Nurse and
otherwise, to get into touch with contacts; but in this matter considerable difficulty
has been experienced, not only in securing primary examination, but in following
the subsequent history of the individuals concerned.
The arrangements under the heading of General Supervision include:—
1. Periodic examination at the Dispensary, when advice is given as to
mode of life and prevention of infection.
2. The supply of medicine to non-insured patients.
3. The supervision of home conditions by the Dispensary Nurse.