View report page

177
CHAPTER III.
PUBLIC HEALTH.
Tuberculosis.
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 arranges for the piovision
of residential treatment required through a public authority (other than
poor law guardians) and Exchequer grant of 50 per cent, is paid on the Council's
approved expenditure. The metropolitan borough councils provide or arrange
for the provision of dispensary treatment and the Council contributes 25 per cent,
of the approved cost, the Exchequer contributing 50 per cent. Various particulars
in regard to the work done under the scheme are given in Chapter I of this volume
(pp. 14-16 and 30-36).
Special inquiry was made into the work carried on at the Cambridgeshire
Tuberculosis Colony, Papworth Hall, where treatment, training and employment
are provided for tuberculous patients. The Council came to the conclusion that
enterprises of this kind, while extremely interesting and valuable, could not ofler
a solution, generally applicable, of the difficult problem of providing suitable employment
or occupation for urban tuberculous persons after discharge from sanatoria.
The Council decided to support a request of the National Association for the
Prevention of Tuberculosis to the Minister of Health for an authoritative inquiry
into the working of tuberculosis schemes throughout the country.
For the purpose of forming a more reliable opinion as to the value of residential
treatment for tuberculosis, it has been decided to make surveys at five-yearly
intervals of the condition of persons discharged from treatment. The first of these
surveys was made in respect of adults and children discharged in 1921.
The tuberculosis dispensary service was the subject of special survey in 1920†.
Recommendations for the development of the service are made to the metropolitan
borough councils from time to time by the Council with the approval of the Minister
of Health. The Council has decided to admit reasonable expenditure on sputum
flasks and paper handkerchiefs for the purpose of its grant.
Arrangements have been approved for the post-graduate instruction of
tuberculosis officers and the provision of "refresher" courses for tuberculosis health
visitors and nurses.
The experimental arrangements in connection with the dispensary service
for treatment in suitable cases by artificial light in out-patient departments of
approved hospitals and other centres were continued for a further period of one
year from 1st April, 1927.
The scheme for the diagnosis and treatment of venereal diseases in the county
provides for the participation of certain authorities near London in the facilities
afforded by selected hospitals for the pin-pose. The arrangements for 1927 provide
for free treatment and diagnosis for in-patients and out-patients at 24 hospitals and
for the reception of patients for treatment at seven hostels. Special provision has
been made for the treatment of pregnant women and very young children. In
pursuance of the policy followed in the development of the scheme all-day clinics
have been established at five of the hospitals referred to and arrangements have
been approved for the provision of an all-day clinic to serve the Western district
of the county. Practitioners secure, at the cost of the Council, scientific reports
for diagnosis purposes on materials obtained from patients suspected to be
suffering from venereal disease, and approved practitioners may obtain, free oi
Venerea
disease
* Scheme for the treatment of tuberculosis in London. No. 2183. Price 4d.
† Tuberculosis in London. Report of the Public Health Committee. 1st July, 1920. No. 2C35.
Price 6d.