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The large class of " dependents" is almost entirely composed of
married women ; those who are engaged in certain trades, e.g., tailoring,
being the employees of their husbands, are not insured.
In regard to insured women, it appears that more than one-third are
domestic servants—an occupation which is responsible for no less than
one-ninth of the total number of adult patients.
So far as a future estimate is possible from the present figures, it
would seem to be probable that even when the Act comes into full
effect, the proportion of uninsured adult patients will still be considerable.
Hence the provision for their treatment is a no less, if not a more,
important factor in dealing with tuberculosis than that for insured
persons under the Insurance Act.
Consideration of Table X (a), (b) and (c) suggests several points of
interest. In the first place it will be seen that more than one-half of
the total number of adult patients received during the year no institutional
treatment (some, however, may have received it in previous years);
secondly that of those patients who received such treatment more than
one-third were away for less than one month (these included many
advanced or chronic cases—some sent merely for educational training—
Poor-law cases and acute or hospital cases; also some patients sent in for
observation only, in order to determine the best treatment), and nearly
two-thirds for no more than two months; and, thirdly, in spite of the
78 patients who were sent away through the Insurance Committee, the
proportion of patients receiving institutional treatment is very little
more among the insured than among uninsured patients, and in the case
of patients in the early stage of the disease is actually less. The
transference of insured patients has enabled the City Council and various
charitable agencies to devote the funds at their disposal for the benefit
of the uninsured, but a more important factor would appear to be the
large number of married men in regular employment who, although
recommended by their medical attendants to apply for institutional
treatment, refuse to do so, if they are able to continue at work, on
account of the difficulty of supporting the family in the absence of the
breadwinner. Even where a patient is able to draw sickness benefit
10s. a week is not an adequate substitute for his own wages of 25s.
or 30s., and after payment of a rent of 6s. 6d. or 7s. little is left for the
sustenance of a family. The regular worker has the fear that if he goes
away for any length of time he will lose his place of employment. It is
a significant fact that of the 65 early patients among insured persons
who were sent away, 10 only, or less than one-sixth, were married men,
although the proportion of married men to other persons in this class is
more than one-third (54 out of 150), and two of these were away for no
longer than one week and three weeks respectively. Probably more
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