View report page

102
result the Council, with the approval of the Minister 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, and it was ascertained that while improvement in certain
directions had resulted since the previous survey, a number of defects still required
to be remedied.
There are now 21 municipal dispensaries, one voluntary dispensary—largely
aided by a borough council—and 8 dispensaries—also aided by the borough councils
—at hospitals. Two borough councils have branch dispensaries.
The medical officers (or tuberculosis officers) of dispensaries number 40, of
whom nine 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 1922 the numbers of new cases examined at the dispensaries were:—
7,843 adults (insured), 6,378 adults (uninsured), and 10,995 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. At the end of 1922, 12 of these proposals had
been approved.
Venereal
disease.
Details are given in the last Annual Report (vol. III., p. 63) of the joint scheme
by the Council and authorities near London for the diagnosis and treatment of
venereal diseases. Arrangements have been made for free treatment and diagnosis
for in-patients and out-patients at 30 hospitals and for the reception of patients
for treatment at nine hostels. Special provision has been made for the treatment
of pregnant women and very young children. Practitioners secure, at the cost of
the Council, scientific reports on materials from patients suspected to be suffering
from venereal disease, and approved practitioners may obtain, free of cost, salvarsan
or its substitutes. The cost of diagnosis and treatment at hospitals and hostels
is divided between the Council and the participating authorities according to the
user of the facilities available. The Council makes direct payments to hospitals
for salvarsan or its substitutes supplied to medical practitioners in London.
These facilities have been fully advertised. The following table shows the
extent to which they have been utilised by London patients during the last three
years the scheme has been in operation.* The number of beds available for inpatients
is 270.
Year. 1920. 1921. 1922.
Number of hospitals 28 29 30
New patients 23,612 19,216 18,219
Attendances 365,478 400,416 434,624
In-patient days of treatment 54,529 54,244 75,413
Pathological examinations for practitioners 11,234 15,385 15,433
Practitioners on the approved list. 297 332 365
* Figures for 1917—19 are given in the Annual Report for 1921 (vol. III., p. 63).