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37
The Local Government Board point out, and emphasise the fact, that it is
the duty of the Medical Officer of Health, upon receipt of a notification under the
Tuberculosis Regulations, either himself or through an Officer acting under his
instructions, to make such inquiries and take such steps as may appear to him
necessary or desirable for preventing the spread of infection, and for removing
conditions favourable to infection. These inquiries will necessarily include investigations
into sources of infection, search for contacts, and inquiry into housing
conditions. The Assistant Medical Officer of Health when not engaged in the
Bacteriological Laboratory is thus occupied in visiting the homes of patients notified
by doctors other than Dispensary Medical Officers, but he has not time to examine
contacts. Subsequent visits are made by the Sanitary Inspectors.
The Departmental Committee expressed the opinion that one Dispensary
would probably be required for every 150,000 to 200,000 of the population, but add
that "much will, however, depend upon the character of the neighbourhood."
To effectually fulfil all the functions of a Dispensary it is advisable for it to
be in as central a position as possible.
In the Dispensary it will be necessary to have the following accommodation:—
General waiting room, consulting room, dressing room, dispensary, and rooms for
caretaker.
I. Staff.—(a) The staff will include a whole-time Tuberculosis Officer, who
will have charge of the Dispensary and who will act as expert adviser to the District
Insurance Committee in regard to diagnosis and treatment of Tuberculosis of insured
persons. It will also be necessary to appoint in Stepney at least one Assistant
Tuberculosis Officer. They should be Officers of the Public Health Department
and under the administrative control of tne Medical Officer of Health. Tnis is
necessary, as otherwise they could not act under the Orders of the Local Government
Board with regard to the steps to be taken for preventing the spread of infection,
or for removal of conditions favourable to infection. These officers will
not, in ordinary cases, undertake any domiciliary treatment except in emergencies,
but will be available as consultants in these cases.
With reference to the duties of these officers, Article 17 of Memo. 112 of the
Insurance Commissioners, is as follows:—
"When the scheme is in full operation, persons, whether insured or not,
"who are suspected to be suffering from Tuberculosis should be examined
"by the Tuberculosis Officer or officers of the Dispensary, who should re"commend
the kind of treatment most suitable for each. The Tuberculosis
"Officer and his assistants could thus act as the medical advisers of the In"surancc
Committee in carrying out his duty of deciding which insured persons