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40
Gonorrhœa
The new patients suffering from gonorrhoea were in 1937 fewer in the case of
men, than in any year since the scheme came into full operation and, in the case
of women since 1921, except for 1931. This, however, may not be entirely a matter
for congratulation as the opinion is generally held that many persons infected with
gonorrhoea do not seek treatment at the clinics. Efforts are, however, being made
by various methods of publicity to induce those who are infected to attend the
clinics.
Prevention
of venereal
diseases
It is proposed, during the year 1938, to obtain from the medical directors ot
the various clinics their views on the working of the scheme, more particularly
from the point of view of preventive medicine. It is hoped to deal with this matter
more fully in my annual report for next year.
Treatment of tuberculosis
The Council is under statutory obligation to make, for the administrative
county of London, adequate arrangements for the treatment of tuberculosis at or
in dispensaries, sanatoria or other institutions approved by the Minister of Health,
and also has power to make such arrangements as it may think desirable for the
after-care of persons who have suffered from tuberculosis.
The arrangements made by the Council in compliance with the foregoing obligation
and authority are published in detail in document No. 3194 (price 4d.), obtainable
from P. S. King & Son, Limited, 14, Great Smith Street, S.W.I.
It will be sufficient to state, in broad outline, that the scheme resolves itself
into two main divisions, viz., (1) a tuberculosis dispensary service provided by the
Metropolitan Borough Councils in accordance with general principles laid down by
the Council, and (2) arrangements for residential treatment and various auxiliary
services undertaken directly by the Council.
The tuberculosis dispensary service is under the administrative direction
of the medical officer of health of each borough. The tuberculosis officers work in
co-operation with the medical practitioners of their area, and their services are
available for consultation. They also act as honorary consultants on the staff of
the Council's general hospitals which serve their areas.
The dispensaries are linked with hospitals for special services, such as provision
for X-ray examinations and artificial pneumothorax refills. The Council's general
hospitals and certain voluntary hospitals are available for these services.
A tuberculosis care committee (or equivalent organisation) is associated with
each dispensary. The constitution of these committees includes representatives of
the various social service agencies, voluntary and public, operating in the borough
to help families whose social and economic circumstances are disturbed owing to the
presence of the disease in the family.
Residential treatment is provided by the Council both in its own hospitals
or sanatoria and in privately owned institutions.
By this method the Council secures a wide choice of institutions of various types
and is enabled to give attention, in addition to clinical considerations, to personal
preferences of patients, an important factor in some cases, and to such matters as
climatic conditions and social or religious amenities. Patients are, however, sent to
the Council's hospitals and sanatoria if beds equally suitable are available, before
accommodation is taken in voluntary institutions.
The arrangements for residential treatment include the provision of observation
beds (a) for the purpose of diagnosis, and (b) to determine disposal for treatment of
definitely diagnosed cases which present difficulty of decision. These " observation "
beds are provided principally at Brompton hospital, St. George's home, Chelsea,
and in the Council's general hospitals. The last mentioned are also used for acute
and emergency cases and for patients with advanced disease who are mainly confined
to bed.
The voluntary institutions used by the Council include Papworth village settlement
and Preston Hall colony where suitable patients have the prospect of
settlement and employment in the industries, and Burrow Hill sanatorium colony,