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"SANATORIUM TREATMENT.
Official sources stats that the waiting lists in general have
been reduced. This is in the main due to many more patients receiving
domiciliary treatment - resulting in many cases in their being able to
return to work without the necessity of Sanatorium treatment sudsing.
But the waiting list for major surgery is still in the region of from one
year to eighteen months. It is high time that the whole question of the
relationship between domiciliary treatment, treatment in the local general
hospital and sanatorium regime was reviewed both from the clinical and
administrative points of view.
The chronic case and the aged still constitutes a grave problem.
The extension of facilities for the treatment of the early case will go
far to prevent the development of the chronic type of lesion. This would
help to cut the present vicious circle of early cases deteriorating
whilst awaiting sanatorium treatment and finally ending up by permanently
blocking a bed in the chronic sick wards of the local general hospital.
Not only would it be possible for many eases who are now put on sanatorium
waiting lists to be treated entirely in the local general hospital, but a
to and fro exchange could be arranged so that patients receiving treatment
in sanatorium and/or general hospital or at home could be switched from
one to the other as the lung lesion changes. In this way it would be
possible to arrive at a state of affairs where the sanatorium and hospital
waiting lists could be reduced to zero and patients would not be in the
unfortunate position they are today of having completed one step of their
treatment and are unable to receive any further treatment because the
institution to which they are waiting to go is unable to receive them.
However, it would be a serious mistake to imagine that this state of
affairs will be achieved merely by the re-assessment of the clinical
condition cf the patient, it would require the opening up of many more
beds in the local general and fever hospitals and the augmentation of
staff and equipment at the chest clinic.
HOME CONDITIONS..
It is true to say that most clinics in the London area have
been forced to undertake domiciliary therapy on quite an extensive scale
because of the long sanatorium waiting list, and because of the
introduction of chemo-therapy which has radically altered the treatment
of tuberculosis of the lungs. Nevertheless, for three main reasons this
type of therapy cannot always be successfully undertaken. Firstly, the
patient may require immediate hospitalisation because of domestic
difficulties. Secondly, the type of lesion and the stage to which it
has advanced may render the patient unsuitable for this type of therapy.
Thirdly, the home conditions themselves may be so bad as to render any
type of domiciliary treatment impossible. For example, this year,