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134
office of the Medical Officer of Health is sufficient for these results.
With all these the Dispensary must be in closest touch, but the
necessary operations are so extensive and varied as to demand
the provision of a special department of Public Health activity.
In connection with the work of the Tuberculosis Dispensary
it will be most desirable to obtain the assistance of a small Aftercare
Committee to secure for patients who have been discharged
from Sanatorium or who have received satisfactory treatment at
the Dispensary, that advice and help about their future life and
work shall be given. This necessity for after-care is set out in
the Interim Report of the Departmental Committee on Tuberculosis.
It will endeavour, in addition to giving advice, in some
cases to obtain suitable occupation, to combat the fear of infection
often felt by employers and fellow employes and to prevent
relapses.
At the start it may only be possible to examine suspected
contacts, but the ideal to aim at later on will be an examination of
every willing contact who has run substantial risks, either at the
Dispensary or at home.
As to finance, when preparing the scheme the Borough
Council will have to arrange with the London Insurance Committee
the terms on which the services of the Dispensary will be
available for insured persons in the Borough. After deducting
the payment made by the Insurance Committee in respect to the
treatment of insured persons, the expenditure of the Borough would
be met as follows:—
(a) 50 per cent. from the Local Government Board.
(b) 25 per cent. from the London County Council.
(c) 25 per cent. out of the Borough rates.
In the 42nd Annual Report of the Local Government Board,
1912-13, it is stated that a Main Dispensary with its branches for
every 100,000 of the population should cost about £1,000 per
annum, or 2.4d. per head of the population; sanatorium or hospital
beds, on the scale of 1 for every 5,000 of the population,
and at 30s. per week for sanatorium beds, and 27s. 6d. per week
for hospital beds, should represent a further annual cost of about