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Preventive measures—In addition to the B.C.G. vaccination schemes, other preventive
measures initiated since 1948 include the chest X-ray examination of all newly-appointed
staff likely to come into close and frequent contact with children, staff at the Council's
training centres for mentally handicapped persons, and of tuberculin reactors discovered
among the children and students tested with a view to B.C.G. vaccination. The X-ray
examinations involved have been carried out mainly at mass radiography units of the
regional hospital boards.
Epidemiological investigations have been made among the contacts of cases of tuberculosis
notified in children, staff or residents in the Council's establishments when no other
source of infection has been established. Similar investigations have been carried out
among adults at those secondary schools where the reactor rates disclosed by tuberculin
surveys were significantly higher than the average for secondary schools in the area or at
that school in previous years.
Care and after-care
Voluntary care committees—Voluntary care committees have continued to operate in
association with most of the chest clinics. These committees, which obtain their funds from
voluntary contributions, sales of work, Christmas seals, etc., have given valuable assistance
to patients by means of money grants, clothes, holidays and other benefits and care not
available from official sources.
Hostels—An important development has been the establishment of hostels for homeless
infective tuberculous men who, if a hostel were not available, would live in common
lodging houses, where they might constitute an infective risk and be less mindful of their
nutritional and other needs than men living a normal family life.
The first hostel was opened in 1951 and there are now three hostels with a total of 91
beds. At the end of the year 88 men were in residence, including nine in similar accommodation
specially provided for the Council's use at a hostel in British Legion Village, Maidstone,
Kent.
These hostels have provided social care and close medical supervision for a group of
men known to take inadequate care of themselves and to have scant regard for the treatment
needs of their tuberculosis. Although primarily intended for homeless infective cases, they
have also provided useful temporary havens for not so infectious cases leaving hospital
but with no arranged home or other living accommodation to which to return.
Industrial rehabilitation—Selected patients recommended by chest physicians are sent
to village settlements, where they undergo courses of instruction in work suited to their
capacity and temperament. By agreement with the regional hospital boards, a patient comes
within the Council's after-care scheme for rehabilitation when he is fit to work at the settlement
for five hours a day. Maintenance charges then become the Council's financial
responsibility until the patient returns home or becomes a settler.
The number of patients at these settlements for whom the Council was financially
responsible rose from 31 at the end of 1948 to 80 in 1954 and fell to 18 at the end of 1964.
Diversional therapy—Diversional therapy classes to provide interesting and profitable
working hobbies were organised mainly by the voluntary tuberculosis care committees
and have continued at some chest clinics for patients able to travel. The instructors are
provided and paid by the education department as part of the Council's evening institute
teaching arrangements.
A service for home-bound patients, started experimentally in 1953 in north west London,
was extended in 1955 to other parts of the county where the need for such a service became
apparent. At the end of 1964 there were 99 patients receiving instruction in their own homes
from the Council's occupational therapists.
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