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133
and which will not necessarily be hampered by considerations of
Municipal boundary lines. When, therefore, the Borough Council
learnt that the Local Government Board had asked the London
County Council to prepare a scheme for the Metropolis, the
Borough Council decided to proceed no further with their consideration
of the subject until the issue of the County Council
scheme. It was not before the end of the year that the County
Council decided to leave the matter in the hands of the Borough
Councils, subject to those bodies making provisions satisfactory
to the County Councils.
In the circumstance, I again reported upon this subject, and
after considering the alternative scheme of obtaining premises and
making suitable provisions within the Borough, the Committee
came to the conclusion that the most economical and efficient
scheme for Stoke Newington was one by which the advantages
of the Metropolitan Hospital, Kingsland Road, may be utilised.
The Borough Council of Hackney had already approached the
Metropolitan Hospital Directors, and obtained an expression of
their willingness and desire to co-operate with that Council in the
establishment of a Tuberculosis Dispensary, and a scheme
embracing both Hackney and Stoke Newington is at present
under discussion.
The aim of a Dispensary System is to secure that not a
single case of Tuberculosis shall occur unobserved or remain
uncared for in the community. The patient is either treated
directly by his medical adviser or at the Dispensary or is sent for
treatment to the proper Institution. In the latter case every effort
is made with reference to his after-care when he leaves the Institution.
In the words of Sir Robert Philips, one of the most valuable
functions of Tuberculosis Dispensaries is to trace the patient to
his home, to get at the "tuberculous nests," to investigate faulty
environment, and to search out tuberculous disease among the
other members of the household, and in turn to see that these are
cared for.
It will be seen that neither the Out-patient Department of
a Hospital, nor the Charity Organisation Offices, nor even the