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a penny rate (₤186,800) would probably suffice for all requirements—if existing institutions were
utilised. The matter cannot, of course, be taken in hand, on this basis, without enabling legislation,
and the sooner this is obtained the better. The national importance of the question seems to be
acquiring popular recognition, and in this fact lies our hope.
HOMES FOR TUBERCULOUS (AND OTHER) CHILDREN
REQUIRING THE BENEFIT OF SEASIDE AIR.
Attention has been called in these reports, on more than one occasion, to the Homes provided
by the Metropolitan Asylums Board, at seaside places, for children requiring the benefit of
seaside air; and to the comments of the Managers' Children's Committee upon the apparent want
of appreciation of the Homes by Metropolitan Boards of Guardians. The Homes were established
in pursuance of the authority of the Local Government Board's Order of 2nd April, 1897, " for
certain special classes of children chargeable to Metropolitan Unions and Parishes." Among them
two of the most important are the " Millfield " Home at Rustington, and the " East Cliff House," at
Margate, for medical and surgical cases of tuberculosis, respectively. With regard to the last
named, the medical officer in charge has on more than one occasion, reported the successful results
attending operations performed for the relief of tuberculosis ; and Sir William Broadbent has
testified to the excellent results attained at the Millfield Home. At East Cliff House, on 8th
September, only 100 of the 134 beds were occupied, whilst at Millfield Home only 76 of the 100
beds were in use; despite the fact that there are in London great numbers of children suffering from
medical tuberculosis, and in receipt of " relief," who might be benefited by seaside air and treatment.
Shortly after that date, the Local Government Board, in a circular letter, urged upon the
Guardians " the importance of their availing themselves of the accommodation and special treatment
" provided at the Children's Homes generally.* It is somewhat surprising that necessity for
making such a representation should have arisen, seeing that the expense of the maintenance of
children sent by the Guardians to the Homes, is defrayed out of the Metropolitan Common Poor Fund.
The Board, further impressed upon the Guardians " the necessity of requiring from the Medical Officers
of infirmaries, etc., systematic reports of children in them whom they may recommend for treatment
" in the Homes—a step said to be necessary as "the Board are informed that, in some
instances, it has appeared that the Medical Officers of an infirmary have not been sufficiently aware
of the accommodation provided." The Board furthermore expressed their "trust that the Guardians
will give the matter their careful consideration, and will take such action as is requisite with a view
to securing that all children of the classes specified, who come under their care, maybe as promptly
as possible removed to such Institutions of the Managers as are suited to their respective requirements."
If this were done, and it is most desirable in the interests of the community, probably a
thousand beds would scarcely suffice for the accommodation of children under 16 years of age,
sufferers from tuberculosis alone. Be this as it may, the Local Government Board, doubtless,
would sanction the provision of whatever accommodation should be shown to be necessary, and
there can be no question of the Asylums Board's willingness to do their part in this matter. In
view of the attitude of both Authorities towards the treatment of tuberculosis in children, their
reluctance to make provision for adult sufferers from pulmonary consumption is inexplicable.
THE NOTIFICATION OF CONSUMPTION.
•
Towards the close of 1901, the Council resolved, upon the recommendation of the Public
Health Committee, to make pulmonary phthisis (consumption) voluntarily notifiable by medical
practitioners, as from the commencement of 1902; and, subsequently, with a view to the utilisation
of the information thus obtained, the Committee authorised me to employ the services of the lady
inspectors (Miss de Chaumont and Miss Looker) in an inquiry into the circumstances of the cases
notified; and, generally, to give effect to the recommendations of their Sub-Committee, whose report
on the subject is printed in the Council's Minutes for 13th November, 1901 (pages 19 and 20). The
work thus inaugurated is still going on, and in submitting the fifth annual report of the inspectors,
I desire to express my appreciation of their services. The report is as follows :—
" During the year 1906, we enquired into all cases of phthisis (pulmonary consumption)
voluntarily notified by medical practitioners; 252 in number (compared with 218 in 1905) of which
80 proved fatal. We made enquiries also with regard to 29 deaths of persons whose illness had been
notified in previous years, and of 105 deaths of persons whose illness had not been notified. The
cases investigated during the year were thus 386 (males 230, females 156) ; the number of visits
paid being 544.
* There are other Homes, for other purposes, than those named.