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(b) That, subject to the provision contained in (c), the Medical Officer
of Health should be named as the officer responsible to the local Council
for the administration of the local Tuberculosis Dispensary, and for the
local execution of the scheme ; but entirely without prejudice to the right
of the Council hereafter to require the payment of reasonable remuneration
to be given to their own Medical Officer of Health and other officers whose
services are utilised in the administration of the National Insurance Act;
(c) That the Chief Tuberculosis Officer of the Dispensary should be
independent of control by any other medical man so far as his clinical
duties are concerned ; but that, in regard to the general conduct and
administration of the Dispensary, he should act under the direction of
the local Medical Officer of Health ;
(d) That the Committee appointed by the Council of the Metropolitan
Borough or City to manage a local Dispensary should have power to co-opt
as members of the Committee persons who are not members of the Council
of the Borough or City which the local Dispensary serves.
After very carefully considering the matter, we have arrived at the conclusion
that the only satisfactory method to adopt in Stepney will be for the Council to be
solely responsible for the management and control of the Dispensary system in this
Borough.
We are strongly of opinion that this system should be a branch of the Public
Health Department, and that the Medical Officer of Health should be its administrative
head responsible to the Council, whilst the officers would be on the staff of that
department with statutory powers under the Tuberculosis Regulations.
We would point out that the present Voluntary Committee is a self-constituted
body of persons who are not responsible either to the residents or ratepayers of
Stepney, whether insured or uninsured, and that its membership may vary from
time to time without the persons most concerned or their representatives being
consulted. We do not desire to minimise the great work which these philanthropic
ladies and gentlemen have performed in the Borough. They have given most
generously of their time and money and have undoubtedly organised an excellent
system which can, with certain modifications, easily be grafted into the Council's
work and which, we think, can now be more advantageously and efficiently performed
under municipal control than as a voluntary enterprise, dependent upon
the good health and willingness to give their services of a number of persons who
might in the future be unable or unwilling to continue their work in this district
and thus jeopardise the existence of their undertaking.
We had hoped, therefore, that means would have been devised whereby the
Dispensaries, their equipment and records should be handed over to this Council