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72
The plan of working through local doctors, approached by the Medical Officer
of Health, generally worked extremely well. In practically every case I saw
and explained the situation to the doctor concerned. In no case was there any
resentment aroused by the intervention of the Public Health Authority. In
every case the medical practitioner was most kindly ready to help me with
advice and information of the greatest use to my plans for the general care of
the families. Had it been possible to continue this friendly co-operation of
the medical profession with the Public Health Department, and with the
Dispensary there can be no doubt that we should have attained results beyond
all expectation. It is among the many disappointments of 1913 that this work
has been wholly discontinued. No scheme, whether for dealing with insured
or non-insured patients (a purely arbitrary decision from the Public Health
point of view) can be satisfactory if the aim is merely the provision of medical
advice and drugs. Consumption is not purely a medical matter, and on the
frank recognition of the problem as one of medico-psycho-sociology depends
much of the success of any measures devised, more particularly those which
apply to the ignorant, the poor, and the helpless, who claim special care from
such a Department as our own.
Decentralization.
As is mentioned in the Report upon Administrative Measures in relation
to tuberculosis by the Chief Clerk of the Department, the Borough Council
has commented upon the difficulties arising from central control of Sanatorium
Benefit. How great and how real those difficulties have been can only be
realized by those in intimate connection with individual cases. On the one
hand the Central Authority is apt to make its decision without full knowledge
of the whole circumstances of the patient. On the other hand the forms
issued, and portions of the letters addressed to insured persons are puzzling to
the less educated among our people. Both in visiting in the homes and at
the Town Hall we have continual requests for help to hasten the action of theLondon
Insurance Committee, to obtain the provision of supplementary
necessaries, to explain the forms, and help in their filling in, and to interpret
the phraseology of the communications.
The introduction of an additional Authority into the Tuberculosis question,,
which is essentially a Public Health matter, seems gravely to have complicated
an already intricate and difficult subject.
Our Needs.
First, and as a condition of effective work in other directions, we needliberal
help, both in money and personal service for our Dispensary.
We need, in connection with the Dispensary, a system resembling that of
the Sick Room Helps, so ably organized by Mrs. Model, in Whitechapel, to
help in the care of the homes and children of our patients.
We want an open air School for the pre-tuberculous, and a Day Hospital
for the definitely notified cases among children.