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Ill
Under such conditions, relapse is only too common, and the
sanatorium is given the blame. There is nothing wrong with the
sanatorium—it has done and still is doing its share of the
work satisfactorily.
In my opinion the present tuberculosis scheme fails in two
important particulars—firstly, the failure to provide a sufficiently
long course of sanatorium treatment, and secondly, the lack of
provision for the placing of ex-sanatorium patients in suitable
employment. The problem is an economic one and should be a
matter for the State. In view of its importance, I make no
apology for again urging improvement in the tuberculosis scheme
on the following lines :
1. A greater measure of financial support for the families of
tuberculosis patients while in sanatorium. The consequent
freedom from worry would enable them to secure a fuller
benefit from their treatment and also permit them to stay
in sanatorium until this is completed.
2. Extension of Village Settlements on the lines of Papworth
and Preston Hall. At these institutions a patient is first
treated for his disease, and when his condition has
sufficiently improved he is trained in some suitable trade.
Later, permanent employment is found for him, while he
lives under ideal conditions in a model hostel or cottage,
under constant medical supervision.
3. Provision of Municipal workshops. Here again patients
would work under strict medical supervision but would
continue to live at home. The class of work and the hours
of employment would in each case be governed by the
patient's physical capacity, and a man should receive a
minimum living wage, irrespective of his earning capacity.
4. The employment of ex-sanatorium patients in tuberculosis
institutions. At first sight it would appear that such an
experiment would be too expensive and risky, but this is
not the experience of Maltings Farm Sanatorium at
Colchester and the Berkshire and Buckinghamshire
sanatorium at Peppard Common, which have employed
ex-patients for some years. Dr. Esther Car ling of the
latter santorium, after twenty-three years experience of
this experiment is full of enthusiasm, and writes :—
" There has been no reason to complain of the services
rendered by the tuberculous. Steady work for thirty
years in one case, for twenty-three years in another, for
thirteen and seven in two other instances, are records of
people on our nursing staff to-day. There have been
occasional periods of sickness, but the Committee's scale
of sick leave has usually covered the case and there have
been few instances of special consideration."