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121
of the village settlement might be considered as an. alternative scheme, but
a large number of patients are temperamentally unsuited for this life.
The Tuberculosis Care Committee succeed in finding employment for a
certain number of our patients, but more frequently all their endeavours
result in failure. The Handicrafts Class, organised by the Hackney and Stoke
Newington Care Committee, makes no pretence of enabling patients to earn
a living, but it provides an interest to occupy their minds and helps to save
them from brooding over their condition. The crafts taught are varied and
useful and include leather, bead, basket and pewter work and the making
of gloves and artificial flowers. The class is run on voluntary lines, since the
Ministry of Health does not sanction the use of public funds for this purpose,
but as the Care Committee have no funds at their disposal, some difficulty
is experienced in raising the necessary money to carry on. Unless further
support is forthcoming, it is feared the class may have to close down—a
step that would be regretted both by the Committee and the patients, who
are keenly interested in the work.
The scheme for the supply of extra nourishment in necessitous cases,
adopted by the Boroughs in 1921, has been slightly modified during the year.
The Public Assistance Committee now undertakes the responsibility for the
provision of extra diet in those cases of tuberculosis already in receipt of
relief, leaving the Boroughs to provide for those cases who do not come under
the care of the former body. This arrangement should prove more satisfactory,
as it will release a certain amount of Borough funds previously
expended on those in receipt of relief and so enable us to extend the grant,
and should also prevent any overlapping. Formerly the borough expenditure
sanctioned by the Ministry of Health was not permitted to exceed £2 per
1,000 of the population, but since the introduction of the Block Grant local
authorities are allowed a greater latitude in this direction. The additional
diet given takes the form of milk and eggs, and is particularly helpful to
patients leaving sanatorium who are unable to provide suitable nourishment
for themselves pending their return to work.
The local authorities' expenditure on special forms of treatment, such as
Finsen Light for Lupus and refills in Artificial Pneumothorax, tends to
increase yearly. Finsen Light treatment of Lupus is on the whole very
satisfactory and effects a cure in a large majority of the cases.
But facial Lupus appears to be peculiarly resistant to treatment, and
relapses are common. A few cases of the latter have now been under
treatment for years, and while we realise the expense involved, we have no
alternative but to persist with Finsen Light, as no other form of treatment
offers anything like the same chance of ultimate cure.
The main cause of the growth of expenditure, however, is the increase in
the number of Artificial Pneumothorax cases, but in view of the encouraging
results of this form of treatment the expense, in my opinion, is completely
justified.
Recently local authorities have also been asked to accept financial res
ponsibility for another special form of treatment, namely, that of Sanocrysin
or gold. In many quarters it is felt that this form of treatment has not yet
passed the experimental stage, and that public authorities should not assume
responsibility for it until its success is more generally accepted.
I submit at the end of this report a statistical summary of the work of
the Department for the year. Apart from a slight fall in the number of new
cases and the total number of attendances in both Boroughs, the tables
presented show no striking variation as compared with those of recent years.
Under the circumstances I, therefore, do not propose to enter into any
detailed examination of the figures.