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44
No residents in common lodging-houses were notified by panel
doctors, though probably some of the more permanent residents are
insured persons. As there are estimated to be 44,000 insured persons
in Westminster, the proportion of tuberculous persons among them
works out at 0.74 per cent.
During the first year's working of the Insurance Act many unforeseen
difficulties presented themselves. The majority of consumptive patients
expected to be forthwith sent away for institutional treatment while
provision had still to be made for it. Pressure of various kinds was
brought to bear to send away patients, and doubtless some cases unsuitable
for sanatorium were sent away. Notwithstanding, however, the
imperfect working which was bound to occur, it may be useful to
examine how the tuburculous patients in Westminster have fared
under it.
Particulars are given of the institutional treatment given during
the year, and of the condition of the patients at the end of 1913, also of
the kind of treatment which they had while at home.
Examination of Table IX brings out the important fact that there is
a large proportion of adult persons who, for various reasons, fall either
altogether outside the scope of the Insurance Act, or through illness or
other cause have failed to become insured, or, although partially
insured, have been unable to receive benefits. The present figures are
not, however, an accurate forecast of those of subsequent years. The
large class of persons who, owing to illness, had been unable to work at
the time of the coming into operation of the Act will naturally decrease
each year. Post-office contributors (of whom only two received
institutional treatment) will, in all probability, also decrease to some
extent. Nevertheless, the number of persons excluded through illness
or from the casual nature of their work from the benefits of the Act, will
not entirely disappear. The more or less chronic ill-health of many
tuberculous persons is a constant handicap in the struggle to secure and
retain regular positions, so that a number of patients drift into a state
of semi-employment, and will always be liable to drop out of a certain
amount of benefit. Young persons of 16 or 17 years of age will, owing
to poor health, postpone entrance into industrial employment, or be
employed only by their parents. The great majority of patients who
are recorded as not insured through unemployment are casual workers,
semi-employment in this case being not immediately attributed to
ill-health.
Hawkers, street-traders, cobblers, lodging-house keepers, small
independent tailors and dressmakers, and other tradesmen make up the
greater part of the class of persons who are noted as not being wageearners.