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Department, etc.) which will help to solve difficulties; make direct provision to necessitous
patients of extra nourishment, clothing, bedding, etc., and arrange for the care of
children while mother is unfit or unable to manage. The tuberculosis care organisers
make an important contribution to the patients' morale and hope by guidance, counsel
and material help. The Council provides home helps to undertake domestic work in
the homes of bed-fast patients and to care in the home for the children of mothers
undergoing treatment. The Council's domiciliary nursing service provides home nurses
who give injections and undertake such other treatment or nursing activities as the
family doctor and chest physician request. Nursing equipment such as back rests, air
beds, bed pans, urinals, etc., is made available on loan to patients in need. The Council
maintains and lends to patients at home, wooden 'chalets' which can be erected
in the garden to accommodate a patient in comfort so as to increase the safety of
young members of the household by enabling an infective patient to occupy 'a room'
by himself. Handicraft classes held at nearly all chest clinics are conducted by instructors
provided by the Council's Education Department. These classes become social gatherings
at which a group of patients can meet once or twice a week, under the eye of the clinic
care organiser, to chat, take tea, make friends and learn and practise embroidery, basketry,
leatherwork, weaving, dressmaking, toymaking, painting, etc., to beguile the boredom
of disablement. For some bed-fast or homebound patients this diversional therapy is
provided in their homes. For the patient too ill to make his own way to the local chest
clinic, the Council provides a transport service of ambulances and ' sitting case cars ' to
convey such patients to and from their homes for consultation, X-ray, pneumothorax
treatment, etc.
For homeless infective tuberculous men, whether fit to go out to work or disabled
by active disease, the Council continued to provide two hostels as described in previous
reports. Hurlingham Lodge, Fulham, had alterations and repainting completed at the
end of July when it came into full use accommodating 28 men. The hostel at Highbury
Quadrant, Islington, was replaced by better premises at Cromwell Lodge, Hornsey,
on 30th September. When adaptations are completed here, the full available accommodation
will be for 31 men. (Further reference to these hostels is made in the reports of the
divisional medical officers on pages 127 and 133.) In addition, and as a temporary
expedient, hostel accommodation was 'borrowed' at Preston Hall, Maidstone, where
the British Legion Village undertook to provide board, lodging and diversional therapy
for 11 ex-service infective tuberculous men under special fmancial arrangements with
the Council. These hostels provide an excellent welfare service of care, comfort, nutrition
and control for a group of infective disabled men who might otherwise spend their
days and nights in the irregular and precarious health conditions of the poorer type of
common lodging houses or similar apartments. During the year 57 recommendations
for admission to hostels from chest physicians of clinics and sanatoria were approved.
At the end of the year 26 men were in residence at Cromwell Lodge, 26 men at Hurlingham
Lodge and 11 at Preston Hall. Maidstone.
Hostels
Most tuberculous persons who have recovered sufficiently to undertake employment
return to their former jobs. So long as the patient is not infective and the physician is
aware of the circumstances all may be well. In the case of the tuberculous worker who, in
spite of treatment, is still infective but who is physically fit enough and determined to
work, the position is not so good. It is seldom practicable for the Medical Officer of
Health, the Health Visitor or the Physician to ensure by periodic visits to the work-place,
that a particular job is safe for those working in contact with the patient.
Since most of the new infections among adolescents and young adults occur at their
places of work, the hazard of the actively diseased tuberculous worker in factory, shop
and office is manifest. For these cases, special employment under close medical supervision
in ' sheltered workshops' easily accessible from the patients' homes in London, is the
answer. There is one such factory, run by Remploy, Ltd., under Government aegis, in
Tower Bridge Road, Bermondsey, where 100 mostly quiescent and non-infective
disabled workers are trained and employed in woodwork.
Industrial
rehabilitation
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