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The following interesting details, relating to Worshops for Tuberculous Persons, have
been contributed by Dr. F. H. Young, M.R.C.P., the City Tuberculosis Officer :—
SOME NOTES ON THE VALUE AND CONDUCT OF WORKSHOPS FOR TUBERCULOUS PATIENTS.
The value of workshops for patients who are, or have been, suffering from tuberculosis
of the lungs must be considered from several points of view.
(1) Economic.—It is obviously of economic value to the Community if any of its members
perform work which, from its commercial value, is able to reduce the subsistence allowance
that public opinion demands should be given to any individual. For example, if a tuberculous
man instead of receiving 30s. as a subsistence allowance for himself, wife and children, when
living in idleness, performs work of a commercial value of 15s. per week for which he is paid
£2 per week, the result is National Economic gain. The question as to where the 25s. per
week is to come from is purely a question of national accountancy. That is to say, that it
is better from the national economic standpoint to pay a partially disabled man a subsidised
wage than to allow him to remain idle on a subsistence allowance provided that the subsidy
is not as great as the subsistence allowance.
The above presumes that the tuberculous man must of necessity remain idle. This is
not always so, although probable in a period of trade depression, when employers are able
to choose their employees, and certain unless the man performs 100 per cent. efficient work.
The latter does not affect the argument, as no scheme for workshops of this kind ought to
employ men who are so far recovered as to be 100 percent. efficient without detriment to their
physical condition. Of those fit to perform less than 100 per cent. efficient work permanently,
there will be a proportion able to do so for a limited period but the result will be eventual
breakdown and it is economically more sound to employ a man permanently at 80 per cent.
efficient work than 100 per cent. for a year or so and later 0 per cent.
The fact that some employers are willing to allow a partially disabled man to do, say
60 per cent. work, and pay him for 100 per cent., from goodness of heart, does not affect the
argument.
(2) Physical well-being of the Tuberculous Patient.—(a) The physical condition of a quiescent
tuberculous patient is improved rather than otherwise by the performance of such an
amount of work as is within his capacity, judged on medical grounds.
(b) The fact that his subsidised earnings are greater than his subsistence allowance will
enable him to provide himself with food, clothes, and lodging, better in quality than previously.
This again will help his disease, as it is well known that the disease is more serious in the poor
than the well-to-do.
(c) The man will be able to live the part of his life which he spends at the workshop under
the sanatorium regime.
(d) The companionship with men who are in the same condition and who have learnt
the same rules of living at the sanatorium, and the fact that he is able to carry out these
rules at his workshop will encourage and help him to carry them out at home.
(e) The man, being employed, will be free from temptation to fall into follies, from the
physical point of view, to which he is liable if idle.
(/) He is prevented from drifting into habits of idleness which will prevent him from
working, even if later he is sufficiently recovered to perform ordinary work.
(g) Owing to the fact that he will be away from home for a considerable proportion of
the day, he will be out of the way of his wife, and cease to add to her already sufficiently
hard-driven life, which is a prolific cause of domestic unhappiness.
(3) Public Health Advantages.—(a) Being under the influence of an environment where
the precautions against the spread of the disease are insisted upon, he is saved from being a
danger to his fellow workers. In ordinary life the individual is largely precluded from this,
as the moment that he tries to carry out the precautions that he has been taught, he is
singled out by his employer and fellow employees as dangerous and is consequently dismissed.
Again the habits he forms at the workshop will be carried into the home and will consequently
much reduce the chance of infection to the very susceptible children with whom he
is in contact.
(b) The time he spends with these susceptible subjects will be reduced.
(c) Owing to the small amount of money available in the home, the wife frequently
goes out to work and the unemployed husband looks after the children with consequent
increased danger of infection.
(d) As the man is employed he will have less time to spend what little money is available,
so the amount available for the home is increased.
(e) The larger amount of money earned, coupled with the larger proportion available,
will enable the remainder of the household to be better fed, clothed and housed.
The advantage of workshops for tuberculous men would, therefore, appear to be very
great, provided that the provision is practicable.
To be efficient there are a number of conditions which should apply to any workshop
scheme.
(a) Position.—It is absolutely essential that the shop should be within easy reach of the
home of the worker. A long tiring journey will have just as deleterious an effect on its subject
as longer hours in the workshop, and the increased fares are an economic drain.
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