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for special reasons to voluntary homes, and a certain number of patients chargeable
to the Council in those homes died or were discharged. The number remaining at
the end of the year was 17.
Epileptics.
There were 36 female and 38 male patients accommodated in voluntary epileptic
homes and colonies, and in each case there were special reasons against their transfer
to the Council's institutions.
District medical work.
During 1934 no important alterations have been made in the organisation of
the district medical service, having regard to the fact that this service is to be
completely reviewed in 1935.
Considerable attention has, however, been given to the accommodation and
equipment of the medical relief stations, with a view to increasing their suitability
for use for the purposes of medical examination and treatment. A detailed survey
was undertaken with a view to bringing the premises, where necessary, to a reasonably
good state of repair ; to remedying any defects in heating and lighting, and to
ensuring an adequate supply of hot water and medical equipment. Additional
furniture has been provided where required, and structural alterations which were
urgently necessary have been carried out.
Certain re-arrangements have been made in the accommodation for district
medical work during the year. Upon the opening of the new out-patient block at
St. Giles' hospital, the medical relief station at Havil-street was closed, and the
district medical officers, who formerly attended that station, are now accommodated
at the hospital. In view of the unsatisfactory accommodation at the Blackwallroad
medical relief station arrangements were made for the district medical work
to be transferred to accommodation at St. Alfege's hospital. It was also found
desirable, for administrative reasons, to close the medical relief station at Bartholomew-close
and to arrange for the district medical officer to see patients at his private
surgery.
Upon the closure of Bartholomew-close medical relief station, arrangements
were made for medicines to be supplied by local chemists. A further extension of
the chemist system was necessitated by the closure of the dispensary at the Albertroad
medical relief station.
There are now 48 medical relief stations of which 32 are equipped with dispensaries,
whilst in the case of the remaining 16 stations patients obtain necessary
medicines from local chemists. There are 19 district medical officers who see their
patients at their private surgeries, medicines being obtained from local chemists.
Medical
relief
stations.
Arrangements have been made under which at the first issue of medicines to
outdoor medical relief patients, bottles are supplied as a matter of routine.
Medicine
bottles.
During the year consideration has been given to the question of providing the
services of a nurse at the medical relief stations. At the time of the review there
were 12 medical relief stations at which the services of a nurse were available each
day, 9 being attended by nurses from an adjacent hospital and 3 by nurses under
other arrangements. At 36 stations no nurse attended, but arrangements of one
kind or another obtained for giving some assistance to the district medical officer.
Experience had shown that the services of a nurse at a medical relief station were
very valuable, and that they raised the standard of attendance upon the patients.
A nurse can relieve the doctor of routine services and give him time to make more
thorough examinations ; she can also undertake work on behalf of the patients too
trivial to justify the patient's being sent to hospital. It is, however, not practicable
to employ a nurse at every medical relief station, owing, in some cases, to lack of
accommodation for her and her work. At other stations the small number of
patients does not justify the employment of a nurse.
It was decided that the provision of nursing services should be extended
gradually to include certain stations where the conditions are suitable and the nurse's
services could be used to advantage. Arrangements were made with local district
nursing associations for the services of a nurse to be provided daily at 4 medical
Nurses at
medical
relief
stations.