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* Including five patients who returned form sanatorium or hospital treatment, and
were subsequently removed to the infirmary.
† Including two patients who returned from hospital treatment and were subsequently
removed to the infirmary.
The waiting period for patients sent away through the Insurance
Committee was anything from nil—i.e., responsibility being taken over
for patients already in institutions*—to fourteen weeks; the usual period
was live weeks.
At first sight the comparatively large proportion of advanced patients
who received institutional treatment appears to be a gain, but of
the large proportion who were treated in the infirmary many did
not avail themselves of it until a late stage, while of the 23 patients
who were sent away through the Insurance Committee, nearly onethird
(7) returned to be subsequently removed to the infirmary,
one-third are dead, and the others are at home in little or no
better condition than before. So that the short stay in the hospital
or sanatorium for many patients was of no benefit to themselves,
and only to a slight extent a means of protection to others. For
the insured, no less than the uninsured, a more adequate provision
for advanced and dying cases is urgently required. The reluctance of
respectable working-class people to apply to the Poor Law is well
known; nevertheless, for the great majority of advanced cases there is
no other provision, and is seldom taken advantage of until the family is
reduced to the last extremity thus a number of advanced cases remain
at home under conditions which render proper care impossible. In
some 20 per cent. (41) of the 218 advanced cases the need for
the removal to an institution was urgent, as well from the point of
view of prevention as from that of ordinary humanity. The efforts
to obtain admittance into a " home for the dying" is evidence that
provision outside the Poor Law would be acceptable. Compulsory
removal or detention in most cases would be unnecessary if the place
* The Insurance Committee now decline to take over such cases.
D 2