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House refuse.
Difficulties in securing an efficient collection and disposal of house refuse throughout the County
were again experienced chiefly during the early part of the year 1919. As the year advanced the majority
of the London boroughs succeeded in coping with accumulations and in maintaining a weekly collection.
Much trouble was, however, experienced in securing the removal of accumulations of refuse in Islington;
difficulties of rail transit and labour shortage led to use of a children's play-ground for deposit purposes.
Representations were made by the Council to the Borough Council and by the end of the year conditions
had improved and in the early weeks of 1920 the deposits had not only been cleared, but a better system
for handling the refuse had been devised.

I The part time officers act in the dual capacity of Sanitary inspector and health inspector.
National Health Insurance Acts—Treatment of tuberculosis.
It will be useful to preface the review of the administration of the Council's tuberculosis scheme
during 1919 with a brief resume of the history of the development of organised provision for the treatment
of the tuberculous population of London, which has already appeared in my annual reports and
other publications of the Council.
The earliest provision seems to have been a voluntary dispensary established in 1909 in St. Pancras;
the eleven dispensaries opened by the Central Fund, for the promotion of the dispensary system for the
prevention of consumption, on various dates during the years 1910-1912; and the Poplar Tuberculosis
Dispensary, which was opened in April, 1912.
Seven borough councils provided tuberculosis dispensaries prior to the adoption of the Council's
scheme—viz., one in 1912 and six in 1913—and in some cases the dispensary work was supplemented
by payment for the treatment of a limited number of patients in sanatoria.
Following the issue in May, 1912, of a report of a departmental committee appointed by the
Government to report upon the general policy which should guide the Government and local authorities
in the matter, the borough councils were invited by the late Local Government Board to submit to them
for approval schemes for the dispensary treatment of tuberculous residents in their respective boroughs,
and later the London County Council was asked to draw up a comprehensive scheme for dealing with
the problem in London in all its aspects.
The Council in November, 1913, adopted regulations in respect of dispensary schemes, conformity
with which would entitle borough councils to 50 per cent. of the net cost to them of the dispeDsary
treatment of uninsured persons, i.e., the cost after deduction of contributions from the London Insurance
Committee and grant from the Government known as the "Hobhouse Grant." The complete scheme
in which these regulations were incorporated was adopted in May, 1914. This scheme is set out in
55580 E