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These dispensaries may actually be provided either at general hospitals or hospitals
for consumption, or at voluntary dispensaries, or by the Borough Councils themselves.
(2) Where there is a general hospital, or a hospital for consumption, situated in
the Borough or sufficiently near to serve as a dispensary for the Borough or some part of
the Borough, and the authorities of the hospital are willing to provide a tuberculosis
dispensary which will comply with any rules which the Board may find it necessary to
make as to dispensaries in London, and to work in co-operation with the Borough Council
and the Loudon County Council, the Board are of opinion that arrangements should be
made for such a dispensary to serve the whole or part of the Borough.
The nature of such arrangements will no doubt vary in different Boroughs, but it
will usually be found desirable that an agreement should be entered into with the
hospital authorities, indicating the nature and extent of the services which they will
provide and specifying the amount of the payment which the Borough Council will make
to them.
A draft of any such agreement should be submitted to the Board and their approval
obtained before the agreement is executed, and a copy of the draft agreement should be
sent to the London County Council when the draft is submitted to the Board.
(3) Where a voluntary dispensary is already in existance which is found to be efficient
and to suffice for the needs of the area served by the dispensary, and the dispensary
authorities are prepared to comply with any rules which the Board may find it necessary
to make as to dispensaries in London and to work in co-operation with the Borough
Council and the London County Council, it appears to the Board that arrangements
should be made for including the dispensary in the scheme of the Borough Council.
In these cases also an agreement should be entered into with the authorities of the
dispensary, indicating the nature and extent of the services which they will provide and
specifying the amount of the payment which the Borough Council will make to them.
A draft of any such agreement should be submitted to the Board and their approval
obtained before the agreement is executed, and a copy of the draft agreement should
be sent to the London County Council when the draft is submitted to the Board.
(4) In cases in which the needs of a Borough or a combination of Boroughs cannot
be adequately met by the utilisation of tuberculosis dispensaries which the hospital
authorities either have established or are prepared to establish at hospitals, or of voluntary
dispensaries already in existence, the Borough Council or Councils should establish, alone
or in combination, a dispensary to serve the areas which would not otherwise be provided
for.
(5) Every dispensary, other than those established at hospitals, should be affiliated
to a general hospital or a hospital for consumption to which specially difficult cases would
be referred for diagnosis or treatment.
(6) It is desirable that beds should be available to which cases needing observation
for the purpose of diagnosis, or for determining the form of treatment best adapted to
the patient's needs, may be sent. The Board consider that such beds should not be
provided at the dispensary itself, but that the most convenient course will be that beds
for this purpose should be provided by the County Council.
2. Preventive Measures.
It is essential that arrangement* should be made for the complete co-ordination of
the work of the dispensary with the preventive work of the Borough Council and their
officers under the Tuberculosis Regulations, 1912.
(i) In the case of a dispensary established by a Borough Council, this will be
secured by attaching the medical officers of the dispensary to the staff of the Public
Health Department of the Council, it being understood that although these officers are
independent of control in clinical matters they will act under the administrative supervision
of the Medical Officer of Health.