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135
7.1d. per head of population, for residential treatment. On this
reckoning the gross annual cost of a complete local scheme is about
9½d. per head of population. Towards this, in the case of the
insured, the repayment possible from insurance funds is about
8d. per insured person. The deficit has to be added to the cost
of treating non-insured tuberculous cases (including the dependents
of insured persons), the total forming a charge on the local
rates, of which Government funds contribute half if the Local
Government Board is satisfied with the local arrangements.
The report states that up to August 30th local schemes for
tuberculosis treatment had been submitted which relate to over
75 per cent. of the population of England. What are termed
"complete" schemes of institutional treatment had been prepared
by 34 out of the 50 English county councils and by 50 out of 72
English county borough councils. Approval had been given to
the appointment of 108 "tuberculosis officers," 63 in counties and
45 in county boroughs. In nine of the cases the approved tuberculosis
officer is also the local medical officer of health, but the
report indicates that this arrangement must necessarily be exceptional.
The present financial aspect of the scheme for "sanatorium
benefit" is by no means satisfactory from the standpoint of County
Councils and County Boroughs. The original is. 3d. provided for
the treatment of insured patients in sanatorium and tuberculosis dispensaries
promised to enable the scheme to pay its way without
being bolstered up by local rates; but now that the amount for
such treatment has been reduced to 8d., the Councils have a considerable
expense to face, and a liability which is not definitely
fixed. It is made clear in the Insurance Act that the liabilities
of Insurance Committees are strictly limited to the amount of the
insurance funds available; and the liability of the Treasury is
limited to the payment of a share of such expenses as they may
have sanctioned; but Councils are to share with the Treasury the
difference between the estimated cost of treating consumptives
and the amount available in insurance funds for the treatment of
the insured, and for all expenditure in excess of the estimated