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The short term treatment scheme, linking Greenwich Chest
Clinic with in-patient beds at Kettlewell Hospital, Swanley, has
continued to work very successfully. A combined hospital-home
treatment scheme such as this has entirely overcome the waiting list
for the treatment of early tuberculosis and patients are now admitted
within 2 weeks of diagnosis. An average stay of three months is
sufficient time for the disease to be brought under control to a point
where further treatment can reasonably be carried on at home.
There is still, unfortunately, a long wait for thoracic surgery,
often up to one year, but it is hoped that this difficulty will
eventually be overcome.

From these figures it will be seen that the volume of work
continues to increase, especially the number of X-rays taken.
It is now an established routine that every case of Tuberculosis
should have his chest X-rayed (often extending over a period of
more than five years) and all contacts of known cases are urged to
attend at regular intervals. Certain special groups such as expectant
mothers, health workers, home helps, emigrants, etc., are also
encouraged to have their chests X-rayed. In addition the number
of patients referred to chest clinics by general practitioners has
increased enormously in the past ten years.
Although large numbers of X-rays cost a large amount of
money, it is only by their widespread use that serious chest disease
can be discovered in its early treatable stage. Modern methods of
detection, control and treatment have reduced deaths from pulmonary
tuberculosis in Greenwich from 67 in 1947 (with a population
20,000 less than at present) to only 29 in 1952. Although the
mortality from tuberculosis has been reduced there has as yet been
no decrease in the notifications of the disease. This, coupled with
the recent rapid increase in the number of cases of carcinoma of
the lung, makes it more than ever important that there should be
no restrictions on chest radiography.