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extent. This may in great part be due to the fact that very many
of the advanced cases in the Borough are with little difficulty persuaded
to enter the local Poor Law hospital, where the conditions
are very good. One patient during the year discharged himself
from one of the London County Council Institutions in order to
re-enter St. James' Hospital because he found the conditions more
to his liking in the latter Institution. The London County Council
provides Institutional treatment for advanced cases of ex-service
men, pensioners for tuberculosis, and besides making use of
St. James' Hospital, several advanced cases have been sent to
St. Luke's Home, Pembridge Villas, and also to St. Joseph's Hospice,
Hackney. Many advanced cases, however, are unwilling to go
away to any Institution, and prefer to remain at home, and, unfortunately,
in several of those cases the home conditions have been
very unsatisfactory. In such cases it seems desirable that powers
should be given for compulsory removal to hospital and detention
there in order to prevent the spread of infection.
No Tuberculosis Dispensary service is complete and no Tuberculosis
Officer can carry out his duties satisfactorily without the
assistance of a Care Committee. The Care Committee of this
Dispensary meets weekly on a Friday at 3 p.m., and much valuable
work has been done in the way of assisting patients and their
families who are in need of assistance in various ways. Close cooperation
is effected by this Committee with the various voluntary
and other agencies in the Borough, the Charity Organisation Society,
the Invalid Children's Aid Association, with the Board of Guardians,
the Emergency Help Fund of the British Red Cross Society, the
United Services Fund, the Soldiers' and Sailors' Families Association,
and with the Local War Pensions Committee. All these
different bodies are represented on the Dispensary Care Committee,
and in this way co-operation is close and effective. Much help for
our patients has been obtained through all those various agencies.
It is realised that patients are unlikely to derive the full benefit from
sanatorium or any other form of treatment if they are worried with
regard to the financial condition of their families whilst they are
undergoing Institutional treatment, and the efforts of the Care
Committee are directed to make such provision for the family as is
necessary before the patient goes away. In the main such efforts
have been eminently successful. In the finding of employment for
patients discharged from sanatorium, however, the services of the
Care Committee have not been so successful, and in this connection
no help whatever has been given by any public body or any Government
Department, and the Labour Exchanges have been unable
to place any of our patients, although many have been referred to
them. Anything that has been done in this direction has been
accomplished by private enterprise. This inability to find suitable
employment for discharged sanatorium patients is the greatest defect
in our tuberculosis service, and no success is likely to be achieved
until such time as the State realises its obligation in this way. A
summary of the work of the Care Committee during the year is
given below.