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52
Tuberculosis
dispensary
service
The tuberculosis dispensary service in London, while forming an integral part
of the Council's tuberculosis scheme, is provided by the Metropolitan Borough
Councils under conditions laid down by the Council and aided by grants from the
Council.
Prior to April, 1933, an annual grant, based on actual expenditure approved
by the Council for the year, was made by the Council to the Metropolitan Borough
Councils, subject to the dispensary service being carried out to the satisfaction
of the Council. Since 1st April, 1933, the Council has substituted, for annual percentage
grants based on actual expenditure, a system of fixed block grants in the
form of annual payments of fixed amounts operating for periods of three years,
based on examination of audited statements of actual expenditure during the
triennium immediately preceding the commencement of each block grant period,
together with a further statement of the amount of the probable expenditure by the
Metropolitan Borough Councils during the ensuing grant period, and reasons for
variations from previous expenditure. This arrangement does not include the City
of London, which maintains its own dispensary at St. Bartholomew's hospital.
There are now 33 dispensaries in all, including 4 branch dispensaries. Of these,
25 are ad hoc municipal dispensaries, and 8 (including 1 branch dispensary) are at
voluntary hospitals and one is under voluntary management. This excludes the
City of London dispensary at St. Bartholomew's hospital. In some cases a borough
has two dispensaries, while in other cases a hospital dispensary serves more than one
borough.
In order to encourage the closer association of the municipal dispensaries with
the Council's general hospitals, special facilities have been made available enabling
the Borough Councils' tuberculosis officers to utilise the hospital X-ray installation
for their patients and also to provide their patients with artificial pneumothorax
refills at the hospitals. This has resulted in an increased number of boroughs
arranging for the whole or part of their work in this connection being carried out
at the Council's general hospitals.
No charge, beyond 2s. 6d., the cost of any film exposed, is made by the Council
to the Borough Councils for X-ray examinations of tuberculosis dispensary patients.
The increased recognition of the value of X-rays as an aid to diagnosis and
treatment has resulted in their more frequent use by tuberculosis officers. The
Council has, therefore, concurred on certain conditions in the provision by Borough
Councils of X-ray apparatus of simple type for the routine examinations in tuberculosis
dispensaries of straightforward cases. Patients whose conditions present
difficulty can still be referred to hospitals specially equipped and possessing specialist
staff.
Detailed information has been furnished by the Metropolitan Borough Councils'
tuberculosis dispensary service as to the work of the tuberculosis dispensaries,
including particulars as to the numbers of new cases and " contacts " examined,
and the number of home visits, etc. The information is summarised in the table
on pages 53 to 55.