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21
Cancer Clinics.
The Public Health Committee of the Council had under
consideration the advisability or otherwise of installing cancer
clinics in the Borough, and in order to guide them in their
consideration of the question, they instructed the Medical Officer
of Health to submit a report in regard thereto. The following is
the Report of the Medical Officer of Health:—
Ladies and Gentlemen,—In accordance with your request, I beg to submit
for consideration the following report on the subject of Cancer Clinics.
There are two ways in which the public health organisation may help to secure
a reduction in the incidence of and mortality from cancer and these are in the bringing
to the notice of the public the knowledge of the causes of cancer as they are known
and of the early signs of the different forms of the disease, and in furthering the
effort to provide proper facilities for the treatment of cancer.
The Borough of Greenwich was the first to give consideration to the question
of establishing a Special Diagnostic Cancer Clinic in London, and in 1927 the
Ministry of Health sanctioned the proposal to start a Clinic in Greenwich as an
experiment for one year, which was subsequently extended for a further period of
12 months. The clinic is held at the Tuberculosis Dispensary ; sessions are held
every Thursday evening at 7 o'clock, and are in charge of the Assistant Medical
Officer of Health.
This officer sees every patient and refers any suspicious cases to a Harley Street
specialist. The specialist receives payment of £2 2s. for each case seen by him
at his consulting room, and the scheme provides for a fee of £7 7s. to be paid to
him should he be asked to attend the clinic for the purpose of conducting a session
of approximately 1½ hours. It has, however, not been necessary up to the present
to requisition his attendance at the Clinic. The Assistant Medical Officer of Health
receives an honorarium of 25 guineas a year for his services, and a nurse is paid
5s. per session. The sum of £100 per annum has been set aside by the Council for
the Scheme charges, but this sum does not include rent, light, heating or cleaning.
During 1928 six men and 25 women attended the Clinic and their total attendances
numbered 49. I am not able to provide any information with regard to the
attendances in 1929, but I understand they are comparatively the same small
number.
A Cancer Control Clinic was also started at Leicester in July, 1927, .and as far
as I know these two are the only Cancer Clinics in the country conducted by local
authorities.
Twenty-two sessions were held at Leicester during the first six months. The
number of patients attending at any one session varied from 12 on the occasion
of the first session to none. The total number of attendances amounted to 61,
on an average of about two or three per session. At three sessions there were no
patients. The 61 attending represented 60 cases, and of these 36 were found not
to be suffering from cancer or to call for further advice.
It will be seen that the Clinic attendances at Leicester were slightly better
than at Greenwich, but it must not be overlooked that Leicester, being a County
Borough, is entirely self-contained, and has one central voluntary hospital into
which, by arrangement, all cases requiring treatment are admitted without delay.
The Clinic is also attended by the honorary surgical staff attached to the hospital.
Camberwell is particularly well provided for in regard to accessibility to London
general and cancer hospitals where expert advice and treatment is readily obtainable
for everyone in the Borough, and in my opinion a Cancer Diagnostic Clinic is perhaps
not so much required in Camberwell as in less fortunately situated districts.
A Radium Centre for the treatment of carcinoma of the uterus has recently
been established at the North Western Hospital and, although no indication can
be given as yet of the results, 54 patients were admitted during the first six months,
of whom 33 have completed their treatment. I am in agreement with the provision
of cancer treatment centres staffed by highly trained surgeons, fully competent