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126
unemployment there is little that we can do. We endeavour, however, in
various ways to ameliorate the lot of patients after discharge:—
1—A constant lookout is kept on the patient for any reactivity of the
disease, and if necessary a further period of sanatorium treatment is recommended.
2—A new house is sometimes obtained either through the Borough
or the London County Council, under a scheme of preferential treatment for
tuberculous cases. 3—Bed and bedding are supplied in certain casts where
the financial circumstances of the patient will not permit of their purchase.
4—The children of infectious cases may be boarded out in suitable homes,
but advantage of this facility is only too frequently refused by parents.
5—A grant of extra diet in the form of milk and eggs is given by both
Boroughs on the recommendation of the Tuberculosis Officer. The total
expenditure sanctioned by the Ministry is limited to £2 per 1,000 of the
population. Formerly it had been our practice to recommend that patients
receive two pints of milk and one egg daily, but after consultation with
the Medical Officers of Health it was decided, in order to extend the benefit
to a larger number of patients, that the supply of milk be reduced to one
pint. Under the change from the percentage to the Block Grant in the
Local Government Act of 1929, a larger Exchequer grant may be expected in
the poorer districts, and a greater latitude in matters of expenditure allowed
to local authorities, so it is hoped that advantage may be taken of this to
increase the allowance for the provision of extra nourishment. 6—We
endeavour through the Tuberculosis Care Committee to find employment for
those who are out of work, but the present state of the labour market often
makes this impossible. The Committee, however, have frequently been
successful in placing patients, notably in the case of women, situations
being found for them in sanatoria as Nurses, sewing maids and ward maids.
7—For those who are unable to find employment we have in Hackney a
Handicraft Class, where patients are taught basket-making, glove-making,
artificial flower-making, and leather, bead, and pewter work. While these
classes do not attempt to enable patients to earn a livelihood, they succeed in
giving them a little pocket money, and what is perhaps more important, they
give patients an interest to occupy their minds and save them from brooding
over their condition. The articles made are sold, and after deducting a
small percentage for class funds the surplus is paid over to the worker.
Orders may also be taken by individual patients, who may sell what they
make under these conditions.
The Boroughs continue to undertake financial responsibility for cases requiring
spccial treatment, such as Finsen Light for Lupus, and refills in Artificial
Pneumothorax cases on their return from sanatorium. The results in both
these forms of treatment are very satisfactory, and the increasing expenditure
incurred is, in my opinion, justified. All patients undergoing these
forms of treatment are periodically examined by the Tuberculosis Officer,
and reports submitted to the Medical Officers of Health as to their progress.
I submit at the end of this report a statistical summary of the work
of the department for the year. From a comparison with the corresponding
figures for 1930 it will be seen that the chief feature of an all round
increase in the figures is the rise in the total number of attendances by
nearly 3,000.
In conclusion I would like to thank the Medical Officers of Health, the
Hospital Physicians and Surgeons, 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.
14th March, 1932.