View report page

94
by living in unhealthy surroundings. The Hospital authorities have also been good
enough to send a number of such cases to their convalescent home at Saunderton,
and I should like to acknowledge gratefully the help of the Resident Medical
Officer and the Lady Almoner in this connection.
The system introduced by the London County Council in 1922 under which the
Tuberculosis Officer sends a special report to the School Medical Officer on all
contact cases of school age, or on any other children examined at the Dispensary
whose health for any reason is found to be unsatisfactory, has been continued
throughout the year. Opinion as to its utility must vary since it has been productive
of no startling results, but at least it ensures a continuity of observation of
such cases that would otherwise be impossible.
A further scheme has been introduced during the year by the London County
Council for removing from their homes, and for boarding out elsewhere, children
living in the houses of tubercular patients. This is carried out by the co-operation
of the Invalid Children's Aid Association, the London County Council, and the
Tuberculosis Officers. A similar scheme has achieved considerable success in
France, but apparently in no other country. The difficulties in the way arise
mainly from the fact that it is hard to persuade parents to surrender their children
to strangers in a home which they have never seen and which they are necessarily
discouraged from visiting. Moreover, it is obvious that it would be a more reasonable
and economical method of securing the same end, i.e., freedom from exposure
to infection, to remove the patient who is the source of that infection, especially
when he has become so ill that his chances of recovery are remote. Nevertheless,
such children as have been sent away and have already returned have in the
majority of cases made great improvement in health.
This question is intimately bound up with that of institutional treatment
n general. During 1925, 206 of our cases were treated in London County Council
institutions. Previously expressed criticisms still hold good—namely, the prolonged
period of waiting and the difficulty of securing accommodation for all,
except war pensioners, who are suffering from advanced disease. The recent
opening of an institution for such cases at Grove Park, which will take in over 320
persons of both sexes, will, it is hoped, bring some relief. Last year, as heretofore,
the great majority of deaths from tuberculosis of inhabitants of Hackney and
Bethnal Green occurred in the local infirmaries or in the homes of the patients.
There is a point in connection with institutional treatment which is a source
of much anxiety: the provision of work for those who have left sanatorium or
hospital, and who have made such progress as would justify one in recommending
them to attempt light work under good surroundings. The unhappy position
of the labour market at the present time renders this problem even more acute
than it would otherwise be, and few employers are prepared to take back a hand
whose working capacity is seriously damaged, and to afford him facilities for
carrying on at a lower productive level. This is a serious handicap, for in many
instances, unless the work and conditions are definitely unsuitable and objectionable,
it is best for the worker to return to that employment in which he has already
attained proficiency, and which therefore entails less wear and tear and anxiety
for him. In 1923 an effort was made by the Ministry of Health, in conjunction