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114
A circular was addressed by the Council to the borough councils giving detailed
information as to work which, it was suggested, care committees might usefully
perform.
Arising out of a proposal approved at a conference referred to below, that
financial assistance should be provided for care committees, the attention of the
borough councils was drawn to the voluntary organisations from which assistance
could be obtained. The Council felt that when the care committees had developed
their work and tested the Council's suggestions it would be found that existing
means for securing assistance would substantially satisfy the needs.
Approved expenditure incurred by borough councils in respect of office and
clerical expenses in connection with the care committees ranks for the Government
grant and the Council's grant towards the cost of the dispensary service.
Tuberculosis
dispensaries.
The dispensary service was the subject of a special survey in 1920.* A further
survey was made in the autumn of 1921.
A conference was held in February and March, 1923, between representatives
of the Council and of the metropolitan borough councils in connection with the
tuberculosis dispensary service. As a result the Council called the attention of
the London Panel Committee and the British Medical Association to the desirability
of securing earlier notification of cases of tuberculosis. The Council also
urged the borough councils concerned to secure closer co-operation between their
public health departments and the dispensary in accordance with Ministry of Health
Circular, No. 149. In order to secure greater co-ordination of the work, borough
councils were also urged to arrange for tuberculosis officers to be appointed visiting
consulting physicians for tuberculosis at poor law infirmaries in their areas. A
circular was issued to tuberculosis officers giving information as to the arrangements
under which they are enabled to visit hospitals and sanatoria in order to keep themselves
posted as to the condition of patients from their areas.
With the approval of the Minister of Health, the Council has approved of
arrangements being made for the post-graduate instruction of tuberculosis officers,
and the borough councils have been invited to submit proposals.
There are now 21 municipal dispensaries, one voluntary dispensary—largely
aided by a borough council—and 9 dispensaries—also aided by the borough councils
and the City Corporation—at hospitals. Two borough councils have provided
branch dispensaries.
The medical officers (or tuberculous officers) of dispensaries, including the
City of London, number 39, 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 to
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 1923 the numbers of new cases examined at the dispensaries were :—
8,245 adults (insured), 7,015 adults (uninsured), and 11,751 children.
The provision of dental treatment in connection with dispensary treatment
Dental
treatment.
* Tuberculosis in London. Report of the Public Health Committee. 1st July, 1920.
No. 2035. Price 6d. The development of the dispensary system was described in the Annual
Report for 1920 (vol. III., p. 110).