London's Pulse: Medical Officer of Health reports 1848-1972

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London County Council 1934

[Report of the Medical Officer of Health for London County Council]

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and provision for intermediate treatment is available also on Sundays and
Bank Holidays. The premises are rented from the London hospital, but the
staff is appointed and the clinic maintained entirely by the Council.
Under the directorship of Dr. T. Anwyl Davies, assisted by a loyal and efficient
staff, the clinic has been an unqualified success. During the first six months the clinic
was in use, 1,527 new patients and 76.183 attendances were registered, whilst for the
year 1934, the number of new patients was 3,885 and the attendances totalled
322,904. Of the new patients during 1934, 64 per cent. of the male and 52 per cent.
of the female venereal cases were infections of less than one year's duration.
The number of pathological examinations made at the clinic for the year 1934
was 88,317, an increase of 5,990 on the previous year's total. Of the 88,317 examinations,
7,563 were made for private practitioners, for whose convenience arrangements
are in force for results of certain tests to be communicated by telephone within three
hours of the delivery of specimens.
Facilities for the study of venereal diseases are available for midwives, medical
students and post.graduates, demonstrations being held weekly.
Treatment of Tuberculosis.
In previous Annual Reports from 1930 onwards, reference has been made to
changes in the administrative methods for dealing with the treatment of the tuberculous
resulting from the operation of the Local Government Act, 1929. As the year
now under review is the fifth year since the Act began to operate on 1st April, 1930,
it may be well to review briefly the developments which have taken place.
Under the original tuberculosis scheme, it may be said that, broadly speaking,
the Council directed its efforts towards providing appropriate residential treatment
for persons likely to be restored to full working capacity, together with the provision
of recuperative periods of treatment for moderately advanced cases with reasonable
prospect of partial restoration to working capacity. Treatment for advanced and
chronic cases was then regarded as the function of boards of guardians. This
position was not rigidly maintained and a considerable proportion of patients sent
into certain of the special tuberculosis hospitals of the Metropolitan Asylums Board
under the tuberculosis scheme, as then administered, were advanced cases. There
were a large number of deaths in these hospitals and they, therefore, tended to become
unpopular and self.discharges were frequent. During the first year for which the
Council became responsible for the administration of the transferred hospitals
and Metropolitan Asylums Board institutions, the existing practice was
largely continued pending experience of the type of case formerly dealt with by
boards of guardians. In course of time, after the hospitals, which had
become organised as general hospitals, had been " appropriated " under the provisions
of the Local Government Act, 1929, tuberculous patients in general hospitals were
removed from the purview of the Poor Law and were dealt with as " municipal"
patients in the same way as other patients in these hospitals. The Council also
continued the practice, in operation under boards of guardians, of placing in
institutions in the country a number of chronic ambulant cases.
In the past the detachment of these cases from the organisation operating the
Council's tuberculosis scheme was a great hindrance in securing consent for admission
to transferred general hospitals of patients who were no longer suitable for institutions
used under the tuberculosis scheme, but who still required hospital treatment.
Among other reasons, the dual visitation for assessment purposes by two separate
organisations caused a considerable amount of irritation. The result was congestion
of hospital cases in sanatoria, and some measure of blocking of the beds for patients
more suitable for the treatment available therein.
The decision of the Council to deal with all cases of tuberculosis as from 1st
April, 1933, under the tuberculosis scheme afforded facilities for dealing with the
matter in all its aspects as a single problem, so that patients could be transferred
between the various institutions, according to their clinical classification, with the
knowledge that their treatment was a continuous service. Assessments were entirely
abolished in July, 1934.