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tuberculous patient lies in the provision of local work shops run by the local
authorities. Here work could be undertaken under ideal and hygienic surroundings
and under direct medical supervision. The class of work and
hours would in each case be governed by the patient's physical capacity.
A minimum living wage, irrespective of a man's earning capacity, should,
be provided in each case with additional pay to those working full time.
The present moment may not be considered opportune to embark on any
scheme involving a large expenditure of money, but I doubt if in the long
run any well organised scheme for the provision of employment would be
as costly to the community as the maintenance of patients in total unemployment.
Moreover, work would give them a renewed interest in life;
they would feel they were once more useful members of society, and this
happier mental state would naturally have a beneficial influence on the course
of the disease.
Under the Local Government Act of 1929 the change from percentage
to block grant is expected to result in a comparatively larger exchequer
grant to the poorer districts for public health purposes. As the Act also
allows the Borough Authorities greater latitude in matters of expenditure,
it is to be hoped that some scheme of employment will receive consideration.
The scheme for the supply of extra nourishment in necessitous cases put
into force by the Borough in 1921, is still in operation. The additional diet
usually recommended consists of 2 pints of milk and one egg daily, and
materially assists those patients who on leaving sanatorium are unable to
provide suitable nourishment for themselves pending their return to work.
The expenditure sanctioned by the Ministry of Health must not exceed £2
per 1,000 of the population, and one would naturally wish to see an
extension of the grant as at present the number receiving the benefit is
necessarily small.
The Borough also provides funds for special treatment such as Finsen
Light, and for the refills in Artificial Pneumothorax cases on their return
from a course of treatment in sanatorium. These patients are periodically
examined by the Tuberculosis Officers and reports submitted to the Medical
Officer of Health as to their progress.
I submit at the end of my report a statistical summary of the work of
the department for the year. The figures show no striking variation and
call for no special comment.
In conclusion I would like to thank the Medical Officer of Health, the
Hospital Physicians and Surgoens, the Resident Medical Officer, and the
Hospital Secretary for their valuable help and advice, and the Dispensary
Staff for their efficient work and loyal support.
H. TYLFORD HOWELL.
9th March, 1931.