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The more stable staff of dispensaries since the war and the increasing experience
of tuberculosis officers has resulted in a marked reduction of cases which, while they
cannot be accepted on clinical reports, can be determined on one physical examination
by a clinical expert at the County Hall, and the doubtful cases now are largely of
a kind which require intensive observation in hospital to determine disposal.
With the passage of time and experience of working " sanatorium benefit " under
the National Insurance Acts, the London Insurance Committee found increasing
difficulty in meeting the needs of insured persons within the financial resources placed
at their disposal under the Acts. County councils throughout the country were
empowered to undertake treatment of insured persons on behalf of insurance committees
on certain financial terms or to make good the financial deficiencies of
insurance committees. The London Insurance Committee appealed to the Council
for assistance in 1919, and an interim arrangement was agreed to by the two bodies
which continued down to May, 1921, when under the National Health Insurance
Act, 1920, residential treatment for tuberculosis ceased to be one of the benefits
conferred upon insured persons under the National Insurance Acts and insured
persons were placed in the same position in this matter as the uninsured population.
As the Council had already acted upon its powers of providing for the uninsured
population it added to its responsibility the provision necessary for dealing with the
largely increased numbers of sufferers for whom accommodation was required in
consequence of this amendment of the Insurance Acts. In the following year the
work was made compulsory on all county councils.
The development of the work is indicated in the following table which shows
the number of cases treated each year since early in 1914. It should here
be mentioned that in 1917 the Council, at the request of the late Local Government
Board (now Ministry of Health), undertook the preferential treatment of men
invalided from the Army owing to tuberculosis, but this work was later transferred
to the London Insurance Committee, and ultimately again to the Council, when the
London Insurance Committee ceased to deal with treatment of tuberculosis as an
insurance benefit, other than as an ordinary medical benefit in line with other
ailments. The Ministry of Pensions, through the Ministry of Health, have reimbursed
first the London Insurance Committee and subsequently the Council for the full
cost of the treatment of ex-service cases. The figures for ex-service men are given
separately in the table.

* Includes ex-service men.
A feature of residential treatment which has its influence both upon the accommodation
required and the ultimate results of treatment is the length of stay in the