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113
The importance of employment as a special feature of the
problem of the treatment of the disease is admitted.
"If the discharged patient cannot be taken back into his old or
similar employment—by far the best thing for him, as we have
pointed out—a new occupation suitable to his condition of health
and capacity has to be sought, and in this search the most helpful
agencies are the care committees and the voluntary organizations
represented on them. To a limited extent such employment can be
found by public authorities, by schemes such as motor-car watching,
etc., and in sanatoria. There remains the method of the special
factory or workshop set up either in association with a sanatorium
run on the colony principle, or by itself. For the town-dweller, the
urban workshop organized locally on a commercial basis, and enabling
the workers to live at home, is by far the better. Such an
enterprise must be substantially subsidized if it is to maintain itself.
It is possible that with good management and by employing selected
patients the loss on such enterprises would be less than the cost of
maintaining the patients at the public charge."
The Council then go on to state that they are anxious to foster
and encourage any promising scheme for the employment of the
tuberculous worker, but that their powers in this direction are
limited. The Council of any County or County Borough has power
to make such arrangements as it may think desirable for the aftercare
of persons who have suffered from tuberculosis; it is not,
however, enabled to set up any trade for the purpose of providing
employment, but may incur expenditure in contributing towards the
maintenance of tuberculous persons during their employment by
third parties. Finally, they add that "the whole question is one of
national and not merely local policy, and we hope that the Minister
of Health will see his way to accede to the request made to him by
the National Association for the Prevention of Tuberculosis and by
the Council to institute an inquiry into the working of tuberculosis
schemes in this country. At such inquiry the question of employment
of tuberculous persons would be thoroughly investigated in all its
aspects, and the Minister would no doubt indicate as the result the
attitude of the Government on the question of financial assistance."
It was stated in last year's report that the results of treatment
by artificial sunlight were not so remarkable as we were led to
expect. Our further experience has justified this opinion, for the
majority of our cases benefited little, and in only one or two instances
has definite improvement followed such treatment. On inquiry I
find that some Tuberculosis Dispensaries have given up this form of
treatment, as the results did not justify its continuance.
In this connection it may be of interest to refer briefly to the
report of the Chief Medical Officer of the Ministry of Health for the
year 1926. He states inter alia that reports from the special centres