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130
During the year 14 children were discharged as fit for work, and employment
was found for them by the school care committee. A strict supervision of
their health is maintained for some years, so that any tendency to relapse
may be quickly recognised. In addition to the discharges, six cases were
transferred to elementary school, further stay in an open-air school being
considered no longer necessary.
In accordance with the London County Council instructions that all
children attending open-air schools should receive an annual holiday, 43 boys
and 22 girls were sent to Broadstairs for a period of two weeks during the
Summer. These holidays are greatly appreciated by the children and are
keenly looked forward to and discussed by them many months in advance.
There is little doubt that they have a beneficial influence on their health.
I have to report the resignation of Miss Carson, the Head Mistress, during
the year. She was an ideal Head for such a school, where individual interest
in the welfare of each child is of prime importance. Her educational success
at Stormont House met with the full recognition of the authorities, but it is
for her ready co-operation in the medical work of the school that I am
particularly grateful.
One hundred and forty cases were admitted to sanatorium or to hospitals
other than the London County Council hospitals, during the year. With
adequate accommodation at their disposal, the London County Council now
never refuse sanatorium treatment for any case offering a prospect of cure
or a reasonable hope of such improvement in health as will enable the patient
to resume work.
Patients with advanced disease are much more readily inclined than
formerly to enter the local general hospital where they know they will continue
to be under the supervision of their tuberculosis officer, but if preference
is expressed for a hospital more remote from their homes, this is invariably
complied with. Formerly, if a patient refused to enter the local hospital he
was left with no alternative but to remain at home. The present policy of
the London County Council of allowing a certain amount of latitude in the
choice of hospitals has removed this difficulty, and has gone a long way to
solve the old time problem of the advanced case.
The steady decline in the mortality from tuberculosis continues. Since the
inauguration of the National Campaign against Tuberculosis some 20 years
ago, the figures have fallen by over 40%—a very satisfactory record.
A higher standard of living and the less virulent nature of the disease
have no doubt contributed to this success, but earlier diagnosis with the
help of X-rays, and recent advances in treatment such as the use of Artificial
Pneumothorax and Phrenectomy, have played a very important part.
But successful diagnosis and treatment are not by any means the whole
picture. Of equal importance is the question of after-care. The rapid
progress seen in diagnosis and treatment is here lacking. After-care
Committees, hampered by lack of funds, can do very little.
With distressing frequency we see the most hopeful case, with disease
quiescent on leaving sanatorium, relapse later from purely economic reasons
although a constant lookout is kept for any reactivity of the disease, and when
necessary, further sanatorium treatment recommended.
With the help of the after-care committee an attempt is made to ameliorate
the lot of the ex-sanatorium patient. A new house or flat is frequently
obtained, either through the Borough Council or the London County Council,
under the scheme of preferential treatment for tuberculous cases. Beds and
bedding are supplied in necessitous cases. A grant of extra diet in the form
of milk and eggs is given by both Boroughs on the recommendation of the