[Report 1938] / Medical Officer of Health, Wiltshire County Council.

  • Wiltshire (England). County Council.
Date:
1938
Catalogue details

Licence: Attribution 4.0 International (CC BY 4.0)

Credit: [Report 1938] / Medical Officer of Health, Wiltshire County Council. Source: Wellcome Collection.

    20/94 (page 18)
    The dentures provided are supplied at special contract rates, a complete set costing only £1 12s. 6d. Where it is at all possible, however, patients are required to repay the whole, or a proportion of the cost by small weekly instalments. There has been no meeting during the year of the local branch of the Hospitals Association formed in accordance with Section 13 of the Act. POOR PAW MEDICAL OUT-RELIEF. On the 1st April, 1930, when the County Council assumed the responsibilities of the old Boards of Guardians, domiciliary medical attention under the Poor Law Acts was provided by 60 salaried District Medical Officers in 69 Medical Relief Districts at a total cost of £5,530 per annum. As these posts became vacant from time to time, through Medical Officers having become super¬ annuate or otherwise, they were only fdled temporarily, and in July, 1930, a scheme which gives the patient free choice of doctor was introduced, with the consent of the Ministry of Health, in the 16 medical relief districts which were then no longer served by permanent officers. Since that date, the scheme, with various modifications, has been extended as other posts became vacant, and at the present time is in operation in 38 districts, with 65 medical practitioners on the panel, leaving 31 districts to be served by 26 part-time salaried District Medical Officers. Full details of the progress and development of the arrangements have been given in previous Annual Reports, and only a brief description is, therefore, given here. Any medical practitioner or his partner who does not already hold a salaried appointment of District Medical Officer under the Public Assistance Committee is eligible to serve on the panel for his particular area, and payment is at the rate of 25s. per patient treated during the calendar year, or 20s. in the Borough of Swindon, with mileage allowance. This payment is regarded as covering the cost of ordinary medicines, but expensive drugs, dressings or appliances are paid for separately. Payment is made at the end of every quarter, and the amount due to each doctor is calculated from the details given on his medical record cards, which are sent to this Office after they have been checked by the Relieving Officers with their lists of medical relief orders issued. During 1938, the aggregate payments under the scheme amounted to £2,793, compared with a sum of £2,971 previously paid in salaries to district medical officers in the area now covered by the revised arrangements. Several of the districts did not, however, come under the scheme until late in the year, and in a full year, therefore, the saving of expenditure as compared with the sum previously paid in salaries would not amount to as much as £180, but this saving will no doubt become greater as the Scheme expands still further. At no time previously has the total expenditure under the Scheme been less than the total amount originally paid in salaries. For some years past there has been a saving in the Area apart from Swindon, but the cost of the work in that district has hitherto brought the total above the amount previously paid in salaries. This, however, was to be expected, as the small salary originally paid to the one District Medical Officer at Swindon 'was out of all proportion to the amount of work to be done. The total number of patients attended was 2,144—831 in the Borough of Swindon and 1,313 in the remainder of the area covered by the Scheme—home visits and consultations at the surgery numbering 17,755, an average of 8.3 per patient. For the Swindon and “ County ” areas respectively the averages were 6.9 and 9.1. The gradual development of the scheme, which has the full approval of the British Medical Association, has been closely watched by the County Medical Advisory Committee, who have given invaluable help in solving the various difficulties which have arisen from time to time. The scheme is at present approved by the Ministry of Health until the 30th June, 1939, and application will, of course, be made for their sanction to be continued.