View report page

159
CHAPTER III.
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 arranges for the provision
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. 28-29 and 40-42).
Tuberculosis.
One of the chief problems in the sphere of after-care of tuberculous persons
is that of suitable employment on discharge from sanatorium treatment. This
question has been under constant consideration, and during the year a comprehensive
report on the subject was prepared by the county medical officer.** The Council
has always been anxious to encourage promising schemes of employment but in
its view the question is one of a national and not of merely local policy. The question
was proposed for investigation at the authoritative enquiry suggested by the
National Association for the Prevention of Tuberculosis into the working of tuberculosis
schemes throughout the country. The Minister of Health did not see his
way to accede to the request for the holding of this inquiry, but with regard to
employment he stated that he was in a position to encourage the provision of further
workshops for tuberculous patients in two or three large towns, and he expressed
the opinion that any inquiry into the question should be deferred until experience
was available of the result of these experiments and further experience had been
gained from the village settlements and workshops already established. The
Council asked the Minister to inform it in due course of the results obtained.
Surveys are made at five-yearly intervals of the condition of persons discharged
from residential treatment. Two of these surveys have been completed in respect
of adults and children discharged in 1921 and 1922.
The tuberculosis dispensary service was the subject of special survey in 1919†.
Developments of the service are made from time to time with the approval of the
Council and the Minister of Health.
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 year from 1st April, 1928.
Experience so far indicates that the best results are obtained when light treatment
is given in conjunction with residential treatment at institutions in the country.
The Council's 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 purpose. The arrangements for
1928 provide for free treatment and diagnosis for in-patients and out-patients at
23 hospitals and for the reception of patients for treatment at seven hostels. Allday
clinics have been established at five of the hospitals, 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
*Scheme for the treatment of tuberculosis in London. No. 2183. Price 4d.
**Employment of tuberculous patients. No. 2545. Price ls.
†Tuberculosis in London. Report of the Public Health Committee. 1st July, 1920. No. 2035.
Price 6d.
16479 L2
Venereal
disease.