View report page

44
(ii) As regards dispensaries established at hospitals, it will be necessary to appoint
a medical officer with suitable qualifications to take charge of the work of the dispensary,
and arrangements should be made for complete interchange of information between the
Medical Officer of Health and the medical officer of the dispensary. Tbe Medical Officer
of Health of the Borough and the County Medical Officer of Health should, of course, be
free to visit the dispensary and should have access to the dispensary records.
The duties of the medical officer of the dispensary should include the examination
of "contacts" and "suspects." The examination would usually take place at the
dispensary, but the officer should be prepared to visit, for this purpose, the homes of
patients in cases where this is necessary. If the authorities of the hospital appoint a
health visitor in connection with the dispensary, it is desirable that her reports on visits
to the homes of patients should be forwarded to the Medical Officer of Health as well as
to the medical officer of the dispensary, and that the health visitor should obtain any
information required by the Medical Officer of Health.
(iii) The remarks in (ii) above will apply generally to voluntary dispensaries other
than those provided at hospitals. It will usually be found that the medical officer and
health visitors of the dispensary pay systematic visits to the homes of patients, and that
unnecessary duplication of visits can be s voided by arranging that the officers of the
dispensary shall be available, so far as practicable, to undertake, under the direction of
the Medical Officer of Health, the domiciliary visits and enquiries under the Tuberculosis
Regulations.
The Borough Council should be willing to furnish the County Council with such
information as is required for administrative and statistical purposes.
3. Duties of Medical Officers of Dispensaries.
Under the Board's Order of 26th July, 1912, relating to the domiciliary treatment of
insured persons suffering from tuberculosis, the medical officer of a dispensary approved
by the Board under the National Insurance Act, 1911, becomes the " Consulting Officer, "
within the meaning of that Order, for insured persons resident in the area served by the
dispensary who are receiving sanatorium benefit in the form of domiciliary treatment;
and in arranging for the services of voluntary dispensaries it should be borne in mind
that the duties of the medical officer of the dispensary will include that of acting as
" Consulting Officer" for the purposes of the Order. Moreover, it has usually been
found convenient to arrange that insured persons applying for sanatorium benefit should
be referred in the first instance to the appropriate dispensary for examination, and it is
desirable that any arrangements which may be made with the London Insurance
Committee for the provision of dispensary services for insured persons in the borough
should provide that the medical officer of the dispensary will be available to examine
such persons and report to the Insurance Committee and to attend their meetings when
required.
The Medical Officer of a dispensary should also be prepared to furnish such information
in his possession as may reasonably be required by any medical practitioner in
attendance upon patients who are also attending the dispensary, and by the medical
officers of residential institutions.
4. Finance.
(i) It appears to the Board that where the scheme of the Borough Council includes
any voluntary dispensary, whether attached to a hospital or not, it is desirable that the
contributions of the Borough Council towards the expenses of the dispensary should be
made in respect of the whole population of the Borough, and that the payment of the
Insurance Committee for the dispensary treatment of insured persons should be made to
the Borough Council. I am to remind the Borough Council that the Government grant
towards the annual cost of schemes is limited to 50 per cent, of the amount chargeable to
rates, and that no portion of the grant will be payable direct to voluntary institutions ;
this consideration should be borne in mind in fixing the contributions to be paid by the
Council towards the expenses of voluntary dispensaries. Similarly, the payments made
by the Borough Council to the hospital with which the dispensary is affiliated should be
regarded as covering the whole population of the Borough. The general principles to be
kept in view are :—