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(a) That the Borough Council are to be regarded as the providing authority for
dispensaries, although the dispensary which will serve the borough may
be provided at a hospital or by a voluntary organisation; and
(b) That the dispensary is to serve the needs of the whole community including
insured persons.
The Borough Council will arrange with the Insurance Committee as to the
contributions to be paid by the latter in respect of insured persons, and the Board think
it would be preferable that these contributions should take the form of lump sum
payments, the amount of which would be subject to revision in the light of experience,
rather than that fees per case should be paid.
Similarly, the contributions made by the Borough Council to the expenses of hospitals
and other voluntary dispensaries should be in the form of lump sum payments.
(ii) I am to refer to the terms of the resolution passed by the London County
Council on the 4th ultimo, which have, as the Board understand, been communicated to
the Borough Council, and to point out that the County Council are prepared to contribute
up to 50 percent. of the net cost of the dispensary treatment of uninsured persons in the
City of London and in each metropolitan borough, after deducting the Government grant,
provided that the County Council are satisfied with the local scheme in force in the area
and that the arrangements and expenditure are annnually submitted to and approved by
the County Council.
As the Board have already explained, all the various agencies should be properly
co-ordinated through the County Council so as to form parts of a complete scheme of
institutional treatment. Each Borough Council should therefore work in close co-operation
with the County Council, and it appears to the Board to be very desirable that the
Borough Council should avail themselves of the offer of the County Council to contribute
towards the cost of dispensary schemes provided by or through the Borough Council.
The scheme of the Borough Council should be forwarded to the London Couuty Council
when it is submitted to the Board, and in those cases in which the Board have already
approved of the general principles of a scheme, but the Borough Council have not yet
fully developed the scheme or have made no arrangements for linking up a dispensary
with a general hospital or a hospital for consumption, the Board should be informed as
soon as possible of the arrangements proposed for completing the scheme and a copy of
the complete scheme should be forwarded to the London County Council.
Where it is proposed to establish new dispensaries, information as to the premises to
be used for this purpose should be supplied to the London County Council when application
is made for the approval of the Board.
(iii) The expenditure of the Borough Council on their dispensary scheme, after
deducting the payment made by the Insurance Committee in respect of treatment of
insured person, and any other contributions, will met as follows:—
(a) 50 per cent. from the Board.
(b) 25 per cent. from the London County Council.
(c) 25 per cent. out of the rates of the borough.
The Board may observe that the promise of the grant of 50 per cent. of the net cost
of schemes is subject to the expenditure being kept within reasonable limits.
When preparing the scheme the Borough Council should communicate with the
London Insurance Committee with a view to arrangements being made between the two
bodies as to the terms on which the services of the scheme will be available for insured
persons residing in the Borough. These arrangements will require the approval of the
Insurance Commissioners.
The Insurance Committee will inform the Insurance Commissioners of the arrangements
proposed and the Council should send similar information to the Board: the
arrangements should not be finally completed until the Board have expressed their
concurrence.