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After Care
Other services provided for the care and after care of patients and contacts include
boarding-out of child contacts; home nursing including the loan of bedding and nursing equipment,
home helps, extra nourishment, rehousing of selected tuberculous families; recuperative hoi idays,
maintenance during industrial rehabilitation at voluntary village settlements and admission to
hostels for homeless tuberculous men.
Statistics relating to these services are on page 89.-
Chest Diseases Care Committees
Three such committees operate in the borough and I append the reports of the consultant chest
physicians on the work of the committees and clinics during the year.
Dr. M. Caplin, Consultant Chest Physician to the Chest Clinic at the London Chest
Hospital reports:
''Since the end of the war there have been notable advances in medicine, but none has
been more dramatic, than the change inithe morbidity'and mortality of tuberculosis. General
improvement in the standard of living has contributed considerably to the reduction in the
incidence of this disease, but the major factor has been'the introduction from 1950 onwards
of anti-tuberculous drugs and preventive vaccination with B.C.G.
Tuberculosis is no longer the scourge it used to be. The disease, however, has not yet
been conquered. The rapid fall witnessed in the fifties has now begun to level out, and the
total eradication of the.disease will still require considerable effort. This effort must
stem from the chest clinic, and in 1969 the diagnosis, treatment; prevention and aftercare
of tuberculosis still formed a primary function of the Chest Clinic at the London Chest
Hospital.
During 1969 the major portion of the work at the clinic was concerned with other chest
conditions which to-day are equally and indeed more severely disabling than pulmonary
tuberculosis. Such conditions are lung cancer, chronic bronchitis and asthma. This area has
had for many years a high incidence of both lung cancer and chronic bronchitis. Recently in
Tower Hamlets about one in four of all deaths in males results either from lung cancer-or
from chronic bronchitis and emphysema. Both these conditions often pose serious social
problems, and the close c.o-opera.tion of the medical and welfare parts of the chest clinic,
developed initially to deal with the social problems produced by tuberculosis is well suited
to deal with the problems of lung cancer and chronic bronchitis.
We are greatly helped in this work by our Chest Diseases Care Committee whose members
are drawn from local statutory and voluntary bodies. However, the financial situation of the
Committee is now causing some concern. The auditor in 1969 commented as follows: ''If the
past.year's level (of expendi ture) H 8 maintained and income isnot increased the funds of the
Committee will soon become exhausted.
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