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being that these committees shall operate until the metropolitan borough councils are in a position to
appoint tuberculosis care committees for each borough area in accordance with the scheme approved by
the Council on the 15th June, 1915 (Council minutes, page 881.5).
The committees are widely representative of all the interests at work, including officials of the
borough council, representatives of the School Medical Service and the Council's School Care
Committee workers. It is noteworthy that the Council had established during the year 28 Interim
committees covering the whole of the administrative county, with the exception of the City of London
and Wandsworth. Stepney has three committees, one attached to each of the Central Fund Dispensaries
in the Borough, and while this report was being written, it has been possible to establish another
Committee to serve part of Wandsworth. These committees have fully justified their appointment,
particularly in connection with children. Visits are made to the homes to ensure that patients comply
with the instructions given as to admission to institutions, to assess and collect the contributions to
be made by parents, to see that the home conditions are made as satisfactory as possible for the return
of the children, to arrange for the provision of extra feeding where necessary and to endeavour
to secure suitable employment after leaving school, etc.
The Council has arranged a scheme of co.operation with the Invalid Children's Aid Association.
In return for grants made by the Council from the contributions paid by parents, the Invalid Children's
Aid Association undertake to arrange for the provision of surgical instruments, treatment at convalescent
homes, and accessories to the treatment of cases dealt with in hospitals and sanatoria under direct
agreements made by the Council.
In addition, it is found that a considerable number of cases for which sanatorium treatment is
applied for, particularly gland cases and surgical cases requiring open air life and surgical dressings
following operation, can be equally well dealt with in institutions of the type available through the
Invalid Children's Aid Association as in sanatoria. Such cases are referred to the Invalid Children's Aid
Association instead of being sent to sanatoria and equal benefits are available from the Council's grant
in respect of these children as in cases referred to the Invalid Children's Aid Association after treatment
in institutions as Council cases.
As an experiment for six months, similar privileges are available for children referred direct by
hospitals to the Invalid Children's Aid Association. During the year 1916, 115 children were assisted
through the Invalid Children's Aid Association with the aid of the Council's grant, which amounted
to £150.
Scheme for the Treatment of Venereal Diseases.
As the outcome of the findings of the Royal Commission, the Local Government Board, in July,
1916, issued the Public Health (Venereal Diseases) Regulations, together with an explanatory memorandum
by their Medical Officer. These regulations were accompanied by circulars to the Councils of
Counties and County Boroughs, Governing bodies of Hospitals and Boards of Guardians, wherein the
attention of the councils were drawn to the necessity in the national interest, for taking immediate steps
to carry out the recommendations in the Report of the Royal Commission, and it was stated that it was
the duty of the Council to proceed at once with the formulation of a scheme for the provision of the
necessary facilities for the diagnosis and treatment of venereal diseases.
The Regulations provide that the Council (a) shall, subject to the approval of the Board, make
arrangements for enabling any medical practitioner practising in the area of the Council to obtain, at
the cost of the Council, a scientific report on any material which the practitioner may submit from a
patient suspected to be suffering from venereal disease, and (b) shall prepare and submit to the Board
a scheme for the treatment at and in hospital or other institution of persons suffering from venereal
disease, and for supplying medical practitioners with Salvarsan or approved substitutes for the treatment
and prevention of venereal diseases. It was further suggested that full use should be made of existing
institutions and that more than one authority might arrange for the treatment of these cases at the same
centre. At an early stage of the deliberations, it became evident that great advantage would accrue
if the local authorities adjoining the county of London, would co.operate with the Council in the
utilisation of facilities to be afforded by the London hospitals. Conferences were accordingly arranged
between representatives of the counties of London, Buckingham, Essex, Hertford, Kent, Middlesex,
and Surrey, and of the county boroughs of Croydon, East Ham and West Ham. The following decisions,
among others, being arrived at:—
(1) That any scheme provided for London would be utilised by many patients from the
surrounding areas, and that it would be equitable for the councils of these areas to contribute
towards the cost of the scheme.
(2) That it was desirable to leave the preliminary negotiations with the hospitals in
London to the London County Council, and that it should be made clear to the authorities of these
hospitals that the facilities provided would be required for patients not only from London but
also from the surrounding areas.
The Council thereupon entered into negotiations with the governing bodies of the principal
London hospitals on behalf of all the local authorities concerned, with the result that 22 of these
institutions intimated their willingness to undertake the treatment of patients, the pathological
examination of specimens and the supply of Salvarsan to authorised persons. The services which it
was proposed should be undertaken by the hospitals, included the appointment of a Committee of the
hospital staff to draft a scheme for carrying out the special work at the hospital relating to the diagnosis
and treatment of venereal disease, and to organise and superintend the arrangements within the hospitals;
the appointment of a competent staff ; the provision of beds for patients the treatment of out.patients