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109
The figures above exclude cases of children referred by the Council to the Invalid Children's
Aid Association for residential treatment under an agreement between the Council and the Association.
The number of children so referred during 1920 was 368. At the end of 1920 there were 155 cases
(95 adults and 60 children) on the Council's waiting list for residential treatment.

In 1913 the Departmental Committee on Tuberculosis suggested tentatively, as a working
standard for residential accommodation, one sanatorium bed and one hospital bed for every five
thousand population. Applied to London, with a population of 41/2 millions, this standard, known
as the "Astor" standard, would give 900 sanatorium beds and 900 hospital beds. Recent evidence
before the Departmental Committee (1919) shows that this standard has proved inadequate in
certain large cities, e.g., Glasgow and Liverpool.
After
history of
patients.
During the year particulars were obtained of the after-history of the Council s patients who
received residential treatment during part of 1914, and during 1915, and of insured persons recommended
for sanatorium benefit in 1914. Of 306 uninsured adults treated, 122 (39'9 per cent.) were not traced,
and of 288 children treated, 89 had passed out of supervision. Of 3,224 insured adults recommended
for sanatorium benefit, 636 (19.9 per cent.) were not traced. The ascertained mortality in each clinical
group, excluding untraced cases, was as follows—
Number of
cases.
Number known after four years to be
Alive.
Dead.
1. Council's patients
(а) Adults (uninsured):—
For diagnosis 5 3 (60 %) 2 (40 %)
Early cases 59 27 (45.8 %) 32 ( 54.2 %)
Moderately advanced cases 97 33 (34 %). 64 (66 %)
Far advanced cases 23 4 (17.4 %) 19 (82.6 %)
(b) Children (pulmonary):—
Diagnosis doubtful 24 20 (83.3 %) 4 (16.7 %)
Early cases 81 78 (96.2 %) 3 (3.8 %)
Moderately advanced cases 48 36 (75 %) 12 (25 %)
Far advanced cases 10 4 (40 %) 6 (60 %)
(c) Children (non-pulmonary)
Hip 16 12 (75 %) 4 (25 %)
Spine 2 1 (50 %) 1 (50 %)
Other bones 4 3 (75 %) 1 (25 %)
Glands 14 12 (857 %) 2 (14.3%)
2. Insurance Committee patients:—
Adults (insured)—
Early cases 552 386 (70 %) 166 (30 %)
Moderately advanced cases 1,417 361 (25.4 %) 1,066 (74.6%)
Far advanced cases 619 20 (3.2 %) 599 (96.8 %)
The figures for insured and uninsured adults are not comparable, as insured persons, of both
sexes, work under the stress of industrial conditions, whilst uninsured persons, principally women, are
not engaged in ordinary industrial life. Moreover, of the 3,244 insured persons recommended for
sanatorium benefit only 1,515 received residential treatment. The results shown above are broadly
similar to those ascertained in other parts of the country.
Contributions.
In accordance with the Council's scheme, when an adult patient, or the person legally responsible
for an adult patient, has an income of £160 a year or more, and the circumstances of the case appear to
justify the demand, a charge is made for treatment. In the case of children, the Council approved the
principle of a small contribution, roughly equivalent to the cost of maintenance of a child at home, being
collected from the parents or guardians of children sent away under the Council's scheme. The
voluntary care committees, who are referred to later, assist the Council in deciding the assessment by
reporting on the financial and social circumstances of the family and advising as to the charge which
they consider reasonable. From the amounts contributed towards the treatment of children grants were
made, as in previous years, to the Invalid Children's Aid Association, a voluntary organisation, for the
purpose of providing for the convalescent treatment of children suffering from tuberbulosis, and also for
providing surgical instruments and other accessories to treatment.