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The figures above exclude cases of children referred by the Council to the Invalid Children's
Aid Association for residential treatment under an agreement between the Council and the Association.
The number of children so referred during 1921 was 331. At the end of 1921 there were 247 cases
(181 adults and 66 children) on the waiting list for residential treatment.
Tuberculosis
dispensaries
—survey of
their work.
The working of the tuberculosis dispensary service in London was the subject of a special survey
during the year 1920.* As a result of the survey the Council, with the approval of the Ministry of Health,
approved, as part of the comprehensive scheme a number of proposals to be brought into effect as soon
after 31st December, 1920, as practicable. A further survey was made in the autumn of 1921, but the
results had not been received before the close of the year.
Development
of the dispensary
system.
The development of the dispensary system was described in last year's report (vol. III., p. 110).
By 1920 there were 29 approved schemes relating to 33 separate dispensaries provided by metropolitan
borough councils, and two branch dispensaries. Thirteen voluntary dispensaries were included as part
of the borough dispensary provision, and continued on a voluntary basis subject to compliance with the
requirements of public authorities until 1920. In that year the Central Fund for the Promotion of the
Dispensary System for the Prevention of Consumption in London intimated that it would not be able
to continue after 31st March, 1921, its grants to the eleven voluntary dispensaries which it had established
and supported. The metropolitan borough councils concerned had, therefore, to consider arrangements
for the maintenance of adequate dispensary services. As a result, nine of the dispensaries were transferred
to the borough councils concerned as from 1st April, 1921, and another (Kensington), as from 1st January,
1922 ; the remaining dispensary will be conducted on a voluntary basis with a grant from the borough
council. Poplar Voluntary Dispensary was transferred to the borough council as from 1st April, 1920.
Two hospital dispensaries were closed in 1921. There are now 20 municipal dispensaries, two voluntary
dispensaries largely aided by the borough councils, and nine dispensaries—also aided by the borough
councils—at hospitals. Two borough councils have branch dispensaries.
The medical officers (or tuberculosis officers) of dispensaries in London number 41, of whom seven
have part-time appointments. In order to co-ordinate the work of the public health departments and
the dispensaries, borough medical officers have been appointed administrative tuberculosis officers, the
position of the tuberculosis officer being assimilated with some limitations to that of an assistant to
the borough medical officer, except in clinical matters, in which the tuberculosis officer is independent.
One half of the cost of approved arrangements for the dispensary service for uninsured persons
is met by Exchequer grant. The Exchequer also makes an annual grant in consequence of the termination
of sanatorium benefit. There are also Exchequer grants in respect of services rendered by the
dispensaries in respect of ex-Service patients. One half of the balance of the cost of such arrangements
approved by the Council in accordance with its scheme is borne by the Council, after deduction of Government
grants for insured persons and discharged soldiers.
During 1921 the numbers of new cases examined at the dispensaries were :—9,819 adults (insured),
6,176 adults (uninsured), and 12,029 children.
Dental
treatment
Proposals for the provision of dental treatment in connection with dispensary treatment were
submitted by several metropolitan borough councils, the Council having, in 1919, decided to regard
dental treatment as an essential part of the tuberculosis dispensary service. During 1921 eleven of
these proposals were approved.
Care
committees,
The late Local Government Board, in 1915, suggested that metropolitan borough councils should
form tuberculosis care committees in connection with local dispensaries, mainly for the purpose of
co-ordinating the activities of public health officers, concerned with the medical side of the work, and
voluntary agencies, concerned with the social side and with the function of providing auxiliary aids to
* Tuberculosis in London. Report of the Public Health Committee. 1st July, 1920. No. 2035. Price 6d.