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107
APPENDIX E.
CANCER.
In accordance with the instructions of the Cancer Sub-Committee given at their meeting
on the 12th March, 1929, I beg to submit herewith an outline of the arrangements that the Committee
may consider desirable for dealing with Cancer in Willesden.
Cancer Centre.—It is suggested that the Centre from which work in connection with Cancer
should be undertaken, should be one of the clinics of the local authority. Here on one evening a
week a doctor and health nurse would be in attendance.
Diagnosis.—The history of the patient presenting himself or herself would be taken by the
doctor and a diagnosis made.
Some cases would be definitely not Cancer, others would be doubtful, and a third group would
be definitely Cancer.
Arrangements would require to be made for dealing with the second and third groups.
Assistance of Hospitals.—In accordance with the instructions of the Committee, I have been
in communication with the Cancer Hospital, Fulham Road; Middlesex Hospital, Berners Street;
St. Mary's Hospital, Paddington; St. George's Hospital, Hyde Park Corner; University College
Hospital, Gower Street; the West London Hospital, Hammersmith; and the Willesden General
Hospital. I beg to attach their replies. From these replies it will be seen that the attitude adopted
by the several Hospitals is as follows :—
(1) The Cancer Hospital.—Cases referred will be regarded as out-patients and inpatients.
No mention is made of any charges or fees.
(2) The West London Hospital.—Cases will be treated, but some definite form of
payment is requested.
(3) University College Hospital.—Treatment of cases will be undertaken, and a fee of
£3 3s. Od. is suggested.
(4) St. Mary's Hospital.—The Hospital is willing to give necessary attention to cases
referred, at a cost of 6s. for out-patients, and £3 13s. 6d. a week for in-patients.
(5) The Middlesex Hospital.—Cases will be seen as ordinary in-patients and outpatients,
without preferential treatment.
(6) St. George's Hospital.—Cases will receive attention, but definite arrangements
as to cost of maintenance are requested. A suggestion of £4 1 Is. 5d. per week is made.
(7) The Willesden General Hospital.—This Institution is prepared to deal with cases
under existing arrangements.
Following-up.—The nurse will assist the doctor at the clinic more particulary in the consulting
room. Outside, she will have to follow up perhaps occasionally in connection with the first group
of cases (not Cancer), but certainly in connection with the second and third groups (doubtful and
Cancer cases), to see that the advice given at the clinic is carried out, or to help the patients to get
that advice carried out or to report on why the patients are unable to carry out the advice given.
All cases sent to the clinic by doctors will receive a communication from the Medical Officer
giving full information as to action taken and advice given.
Propaganda.
It is probably mainly as a result of propaganda that patients will attend at the centre established
by the local authority. Samples of propaganda material in use at Bradford, Greenwich and Leicester
are attached, as well as the Cancer Leaflet of the Central Council for Health Education. Similar
propaganda material suitably modified would be issued from the centre and could be distributed
through the Municipal Clinics at ordinary sessions. Other methods of propaganda would be by
occasional articles in the local press and displays of suitable posters throughout the district giving
information as to the facilities provided by the local authority for the early diagnosis of Cancer.
Cancer Sub-Committee.—I think if the Centre is decided upon the Cancer Sub-Committee
should be kept in being so that they may keep in touch with the development of the Centre and
particularly edit from the lay point of view the propaganda material which it is suggested should
be issued from the Centre.