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Tuberculosis Officer. The children of infectious cases are boarded out in
suitable homes by the London County Council. The Tuberculosis Care
Committee endeavours, with occasional success, to obtain work for those
who have lost their employment. The Hackney and Stoke Newington Care
Committee also run a Handicrafts class, where patients are taught, among
other things, basket making, glove making, artificial flower making, and bead,
leather, and pewter work. These classes do not attempt to enable patients
to earn a living, but they provide a little pocket money, and what is more
important, they give patients an interest to occupy their minds and keep
them from brooding over their condition. It will be seen that all these
efforts merely lighten the burden of the tuberculous but do not in any way
get at the root of the matter—the provision of suitable employment to enable
a patient to provide adequate nourishment for himself and family.
In my opinion a plentiful supply of good food is the first essential in a
patient's fight against tuberculosis. No one will deny that fresh air is
desirable and improved accommodation often necessary, but removal of the
family to a larger house or flat, if it entails increased demands in the form
of rent upon an already restricted income, is a short-sighted policy and often
does more harm than good, as less money is then available for food.
The majority of patients on leaving sanatorium are capable of work under
suitable conditions, but they are not able to compete in the open market
with able-bodied men. Their working capacity has been damaged, and
their earnings may have to be subsidised for some years. The problem of
supplying work for these is one of such magnitude that it can only be
satisfactorily solved by the State. It has hitherto been shelved on the grounds
of expense, but I doubt if a well-thought-out scheme would be as costly as
would at first sight appear to be the case. It would surely be less expensive
to utilise a man's earning powers than to keep him and his family in complete
unemployment. We have been shown the lines such a scheme should take
by several noteworthy experiments in the past.
In the village settlements of Papworth and Preston Hall patients live
with their families under strict medical supervision and in ideal hygienic
conditions until their disease has been arrested for a period of five years,
when they may be regarded as cured, and are free once more to live normal
lives. Patients are paid a living wage for their labour, the two colonies
between them paying £50,000 yearly in wages, and selling goods to the annual
value of £200,000. The scheme of municipal workshops might also be given
an extended trial, under which also patients would work under strict medical
supervision, but would continue to live at home. The class of work and hours
should in each case be governed by the patient's physical capacity. A
minimum living wage, irrespective of the man's earning powers, should be
provided with additional pay to those working full time. One disadvantage
of the scheme is that the home conditions of patients do not receive special
supervision. It should not be impossible, however, to devise some means
of overcoming this. Other experiments have been tried, but on account of
expense or for some other reason, have not been a success.
Burrow Hill Colony, while not attempting like Papworth and Preston Hall
to solve the problem of unemployment, is doing very useful work in another
direction. Youths from 13 to 19 years of age continue their treatment at
the Colony, and at the same time are trained in horticulture or clerical work
according to individual capacity or inclination. A reasonable educational
standard is first ensured by attendance at the Colony school. The training
in horticulture includes a theoretical course in addition to the practical.
By an arrangement with the London County Council a certain number of
boys trained at this Colony are, on their discharge, found employment in
their Parks department. On the clerical side the technical training includes
shorthand, typewriting, book-keeping and commerce, and employment is
found for the trainees on completion of the course.