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76
PREVENTION OF ILLNESS: CARE AND AFTER-CARE
Tuberculosis
Throughout the year the Council has continued to provide facilities for the care
and after-care of tuberculous patients and the prevention of tuberculosis as part of the
National Health tuberculosis service, the diagnostic and therapeutic aspects of which
are dealt with by the metropolitan regional hospital boards. Considerable, and
sometimes complex, arrangements for integration of the services and liaison with the
metropolitan regional hospital boards, the boards of governors of teaching hospitals,
and hospital management committees have been necessary to ensure that the available
resources are used to the best advantage for tuberculous persons and their families.
Chest
clinics
There are 29 chest clinics in the County. In some of the larger boroughs there
are two clinics, but some combinations of boroughs are served by one. These clinics
had on their books on 31st December, 1951, 34,043 patients, of whom 30,459 were
suffering from pulmonary tuberculosis. The medical staff, the radiographer and the
physician's clerks are provided by the metropolitan regional hospital boards, which
also maintain the premises and equipment. The Council rents from the hospital
management committees the accommodation used by the staff it provides, which
includes care organisers and their clerks, handicraft instructors and a number of
tuberculosis health visitors who spend part of their time assisting the physicians in
clinic work. The majority of the health visitors' time is spent in visiting patients in
their homes to ascertain the domiciliary, social, and economic conditions under which
the patients live, and where necessary, to endeavour to improve them. The aftercare
organisers at the clinics are concerned with the patients' needs other than medical
and nursing; they also act as the secretaries to the local tuberculosis care committees.
Care
committees
The Divisional Tuberculosis Care Committees appointed by the Divisional
Health Committees have continued their work of co-ordinating the activities of the
Tuberculosis Care Committees, sub-committees or other groups of persons authorised
by them to deal with tuberculosis care work in the divisions.
Care
organisers
and
local care
committees
The importance of relieving tuberculous patients of domestic, social, industrial
and financial anxieties has always to be borne in mind, notwithstanding that necessitous
tuberculous persons receive higher financial grants from the National Assistance
Board than do other necessitous persons. This is the special province of the tuberculosis
care committees and care organisers. In 1951, these officers made first
investigations in respect of 6,383 patients; 2,343 newly assisted patients received
extra nourishment; 553 were provided with beds and bedding; 687 were provided
with nursing requisites; 1,019 were provided with clothing and 291 with other
commodities. At the end of the year 1,537 tuberculous patients were receiving extra
nourishment from the Council or care committee resources and 536 were receiving
the services of home helps. In addition to arranging for the provision of food,
clothing, etc., as outlined above, the Council's after-care organisers made arrangements,
where possible, for better housing, more suitable employment, foster homes
for child contacts, diversional therapy, and gave help or guidance in many other
problems of personal or familv concern.
Home
care and
treatment
At the end of 1951, there were 773 tuberculous persons in London awaiting
admission to hospital, compared with 1,513 at the end of the previous year. 658
patients (compared with 1,678 at the end of the previous year) were under special
treatment in their own homes. Many of these were awaiting admission to hospital,
but where the patient's domestic and home conditions permitted, chest clinic physicians
introduced home treatment by rest, chemo-therapy, collapse therapy, or
combinations of these forms of treatment. This involved the services of health
visitors, home nurses and home helps, and the boarding-out of susceptible children
from the homes to avoid the risk of infection or to reduce the domestic work while
mothers were undergoing treatment at home. At the end of the year 408 patients
were receiving attention by the Council's home nursing service.