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44
that this matter has received much sympathetic consideration, and
a scheme is now before the Ministry of Health and the London
County Council for making provision something on the following
lines—
The discharged patient who is certified to be able to work, say,
only half-time, will be admitted to this working centre, and there
taught a new occupation, which can be carried out under fresh-air
conditions. At the expiration of the half-day which he is allowed
to work, he will be kept under further medical supervision for the
remainder of the day in the recreation or similar room, and at the
end of the week the amount that he may have earned at the new
occupation will be subsidised to bring up his earnings to a standard
rate of wages commensurate with the needs of his family, and
as his earning power increases so the amount of the subsidy would
be decreased. In this way his period of sanatorium treatment will
be extended in this working centre, during which time he will
have been taught a new occupation, and it is hoped that his physical
condition will so much improve that he will eventually be able
to work full time at this, or possibly even his old trade, providing,
of course, that the physical conditions under which such work will
be carried out will be satisfactory. It is proposed that the money
to make up a patient's earnings to the living wage agreed upon shall
be provided by the Poor Law Authority, who are very sympathetic
towards the scheme, and have asked for the consent of the Ministry
of Health to join in with the Borough Council in this way. It is
hoped that during the current year some definite steps will have
been adopted on these lines.
Day Sanatoria for Children.
The attention of the London County Council has been drawn
to the necessity of making some provision of this character in this
immediate neighbourhood, and it was suggested that arrangements
be made for holding classes in the Greenwich Park or in other
premises which had been suggested to the London County Council
from time to time. Unfortunately up to the present nothing of this
sort has been provided in this district.
During the year whilst I was acting as Tuberculosis Officer
during the absence of the Tuberculosis Officer on military service,
I was struck by the large number of cases of patients who were
sent to the Dispensary, or came to the notice of the Department
in other ways, in such a comparatively late stage of their illness,
and on making enquiries I found that they had been under treatment,
frequently for long periods of time, for vague diseases, i.e.,
debility, anæmia, indigestion and the like, and it was only when
the case became very advanced that a notification of Tuberculosis
was sent in, being then very frequently accompanied by a request
that immediate steps should be taken to obtain the patient's removal