London's Pulse: Medical Officer of Health reports 1848-1972
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Hints from the Health Department. Leaflet from the archive of the Society of Medical Officers of Health. Credit: Wellcome Collection, London
London County Council 1923
[Report of the Medical Officer of Health for London County Council]
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113
Tuberculosis
—History.
CHAPTER XXV.
Public Health.
The responsibility in London for the public provision of treatment for tuberculosis
rests on the Council, which in 1914 prepared a comprehensive scheme,
revised in October, 1922.* Under this scheme the Council provides or arranges
for the provision of residential treatment required through a public authority (other
than poor law guardians) and the metropolitan borough councils provide or arrange
for the provision of dispensary treatment. The scheme specifies (clause 40) the
working arrangements into which the Council is prepared to enter with the authorities
of other county areas with regard to certain cases in which questions may arise
as to the county authority which should be responsible for the provision and continuance
of any course of residential treatment. Further details are given in the
Annual Report for 1922 (vol. III., p. 100).
The following table shows the provision for residential treatment under the scheme (excluding insured persons and ex-service men)†:—
| Year. | New cases admitted during year. | Beds occupied at end of year. | ||||
|---|---|---|---|---|---|---|
| Adults. | Children. | Total. | Adults. | Children. | Total. | |
| 1920 | 932 | 1 1,167 | 2,099 | 306 | 704 | 1,010 |
| 1921 | 1,215 | 1,050 | 2,265 | 225 | 669 | 894 |
| 1922 | 1,024 | 906 | 1,930 | 250 | 655 | 905 |
| 1923 | 975 | 749 | 1,724 | 285 | 707 | 992 |
The following table shows the provision for residential treatment in London for insured persons and ex-service men:—
| Admissions during year. | Beds occupied at end of year. | |||||
|---|---|---|---|---|---|---|
| Insured adults. | Ex-service men. | Total. | Insured adults. | Ex-service men. | Total. | |
| 1920 | 2,320 | 3,045 | 5,365 | 712 | 618 | 1,330 |
| 1921 | 3,356 | 2,544 | 5,900 | 727 | 430 | 1,157 |
| 1922 | 3,121 | 1,289 | 4,410 | 835 | 285 | 1,120 |
| 1923 | 2,298 | 1,304 | 3,602 | 822 | 351 | 1,173 |
The above figures 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 1923 was 102. At the end of 1923 there were 170 cases (145 adults and 25
children) under consideration for residential treatment. Details of treatment are
given above (see pp. 46/.)
Care
committees.
In accordance with circular No. 308 (8th May, 1922) of the Ministry of Health,
schemes have been submitted by the metropolitan borough councils for the establishment
of permanent tuberculosis care committees composed of representatives of
local authorities, boards of guardians, insurance committees and charitable and
social work organisations in the district. Such committees are now in operation
in nearly all the metropolitan boroughs.
The functions of the care committees are generally to look after the welfare and
interests of patients, to render such advice and assistance as circumstances dictate,
with a view to enabling a family to adjust its circumstances to the new conditions
and to derive the fullest advantage from the medical treatment prescribed; and
further, to co-ordinate voluntary effort for the provision of certain kinds of assistance
that may be needed in particular cases, e.g., additional food, change of air,
clothing, etc. A subsidiary but important function of the care committees is to undertake,
on behalf of the Council, the assessment of charges made in proper cases in
respect of residential treatment afforded to children and adults.
* Scheme for the treatment of tuberculosis in London. No. 2183. Price 4d.
† Figures for 1914-19 are given in the Annual Report for 1921 (vol. III., p. 62).