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The latest analysis of the work of the London Dispensaries issued by the
Ministry of Health shows that the average number of X-ray examinations per 100
"new cases" and "contacts" examined is 17, and that the Woolwich figure is 20.
The original arrangement made with the Seamen's Hospital Society in 1921
has concluded, and the X-ray work is now done at the Woolwich War Memorial
Hospital, which is much more convenient for patients.
(i) Observation Cases.—Observation cases are those in which no definite
diagnosis of tuberculosis has been arrived at during the first month. A number
of these fail to continue in attendance, but a check is kept upon these cases by
going through their case papers at the end of each month, and, if they are not
attending, the Tuberculosis Visitor endeavours to get them to visit again.
(j) Co-operation with Local Practitioners.—During the year 67 new cases were
seen by the Tuberculosis Officer at the homes of the patients, and 403 were referred
to the Dispensary by medical practitioners in the Borough.
(k) Co-operation with the School Medical Service.—There is intimate relationship
with the School Medical Service and the Dispensary. Many cases are referred to
the Dispensary by the School Medical Officers, and the child contacts of tuberculous
patients are referred to the School Medical Service for special observation
and supervision. The Divisional School Medical Officer and the Tuberculosis
Officer, in personal consultation, discuss these contacts and decide on the supervision
desirable. Other children, whose condition is unsatisfactory, are referred
to the School Clinic for the treatment of minor ailments and dental caries, or to
the School Care Organiser with a recommendation as to the provision of milk and
cod liver oil to be given at school.
(l) Extra Nourishment.—Extra nourishment, in the form of butter, eggs, and
milk, is supplied to tuberculous patients on the certificate of the Tuberculosis
Officer. The object of this measure is to help the ex-sanatorium patient and other
suitable cases by the provision of such extra nourishment as will make the difference
between progress and relapse ; it is not intended for advanced cases of tuberculosis
where real improvement cannot be expected. The expenditure on this service is
limited to £2 per 1,000 population.
(m) Dental Treatment.—Dental treatment is carried out under the Council's
scheme at the School Clinic, Brewer Street, During the year 23 cases received
treatment, the number of attendances being 50. The only charge made to patients
is in connection with the supply of dentures, and then patients are assessed according
to their means. Dentures were supplied in 16 cases at a cost of £62 19s. 0d., and
payments by patients amounted to £27 6s. 3d. In assessing patients, due regard
is given to dental benefits they may be entitled to from approved societies,