View report page

53
"That, as regards London, it should be considered whether some of the
sanatoria and hospitals required should not be provided by the
Metropolitan Asylums Board, and whether dispensaries should not be
provided by the metropolitan borough councils."
Action taken by the Government—The Local Government Board in a circular
letter, dated 14th May, 191 2, called attention to the report of the Departmental
Committee, and stated that they agreed generally with the findings of the Committee,
including the financial recommendations in regard to the distribution
of the capital grant. The Board suggested that the council of each county and
county borough should forthwith take the matter into serious consideration,
and by conference and consultation with the other councils, determine what
action they should take. As a first step in formulating a scheme, the Board
suggested that the Medical Officer of Health should be asked to submit a report
setting; out the existing means for the treatment of tuberculosis within the
county or county borough, whether in the hands of local authorities or otherwise,
and his estimate of the needs of the area generally.
It was followed by a further circular letter, dated 6th July, 1912, addressed
to county councils, and county borough councils, dealing with provisional
arrangements for the treatment of insured persons recommended for sanatorium
benefit, and urging that complete schemes relating to the whole population,
and not only to insured persons, should be prepared in conference with the
insurance committees and sanitary authorities, the unit area for such schemes to
be generally the county or county borough.
On the 27th July, 1912, a further letter was sent by the Board to county
councils, sanitary authorities and insurance committees in England and Wales
relative to the domiciliary treatment of insured tuberculous persons and
•enclosing copy of an Order under Section 10 (1) [b) of the National Insurance
Act.
In this letter the Board observe that when the provision for combating this
disease which has been recommended by the Departmental Committee on
Tuberculosis is complete, a dispensary with an expert consulting officer will be
available in every area as part of the general public health organisation. The
Order provides that the consulting officer of a dispensary approved by the
Board shall be the consulting officer for the purpose of the regulations, and
that until such officer has been appointed, the Medical Officer of Health of
the county or county borough shall act in that capacity, outside London, and
in the Metropolis, the Medical Officer of Health of the Sanitary Authority.
Article If. of the Order provides that the treatment shall be carried out
under the care and direction of a Medical Practitioner subject to the following
conditions, and to such other conditions as the Board from time to time approve,
that is to say :—
(1) That the Medical Practitioner attend each patient at such intervals as
may be necessary in the interest of the patient.
(2) That the Medical Practitioner give the patient such instructions as
are required as to his mode of living, diet, rest and work, and as to
precautions necessary to protect the patient against re-infection.