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144
instruction respecting Pulmonary Tuberculosis, and the
precautions to be taken against the spread of infection from that
disease.
The article clearly gives local authorities powers, not only to
establish tuberculosis dispensaries and to maintain them, but it
also authorises them to undergo expense in removing conditions
favourable to infection. Under this latter head might be included
the provision of beds, extra rooms, shelters and special forms of
food, and other accessories of treatment. The article also enables
them to bear the expense of spreading information as to the nature
of this disease, and the mode of preventing its spread.
I have given these details in order to show if possible the relative
importance of medical treatment and preventive treatment, in
the scheme for diminishing the prevalence of Tuberculosis, and
ultimately eradicating it from the Borough. While mcdical treatment
should be given to all cases, in the hope of curing or
ameliorating the disease, the limitations of such treatment should
be borne in mind. At the same time preventive measures should
take the first place, and be applied, wherever there is opportunity
of preventing the conveyance of infection.
I will now deal with the four points upon which I am requested
to report, taking them seriatim.
Suggested arrangements which should exist as regards—
(1) The fees to be paid to dispensaries and doctors.—I do not
think it will be at all practicable to pay dispensaries and doctors
by the same method or scale of payments. I am of opinion, taking
all points into consideration, that dispensaries should be paid
\per capita, i.e..—a certain sum per annum for each separate patient
treated at the dispensary. I think this should not be less than
30s. per head, and it might, considering the useful role the dispensary
may come to play in the treatment of tuberculosis, be substantially