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immediately, and at the present time there is seldom any resentment
at notification on the part of the patients or their friends.
Notification has been in force sufficiently long to have brought
about an appreciation on the part of the public of the object and
value of notification. The public know that there is a Tuberculosis
Scheme, but only in a vague sort of way; they do not know the
details; in what way the scheme deals with diagnosis, treatment
and prophylaxis; these details are very frequently only brought to
their notice as the result of the information imparted when inquiries
are made after notification. The inquiries are made in a discreet
manner, and if the patient is able to obtain, if necessary, expert
advice and sanatorium treatment no further action is taken by us
which would appear irksome. The delinquent doctors, therefore,
are lacking in their care of the patient as well as in their public
duty by neglecting to notify the cases early and promptly.
Another difficulty which occasionally arises and militates
against the success of the Tuberculosis Scheme is the housing
difficulty. This matter has been referred to in other reports.
Housing accommodation is not sufficient to meet the demand, and
even if there were sufficient accommodation, economic conditions
are such that the sufferers are not in a position to pay the rent.
In some cases there is actual legal overcrowding in the families of
those who suffer from Consumption. For instance, the mother of
a family was notified and the family consisted of husband, wife
and 5 children aged respectively 11 years, 10 years, 8 years, 6
years and 3 years. The house in which they lived belonged to
the wife's mother and the latter sub-let two rooms. We arranged
with the patient's mother so that her daughter should have a
separate bedroom when discharged from the sanatorium. But
there are other factors than housing accommodation in this case
and I have mentioned it because it is typical of many others. The
social and economic factors are quite as important. The husband
was a general labourer earning under three pounds a week. If he
had to rent a decontrolled flat of such a size as to allow his wife a
separate room, the rent would be at least 25s. per week. But
with a family of 5, and especially with a consumptive wife, he
would find it extremely difficult to obtain a flat or house at a
reasonable rent. The case also illustrates the harmful effects of
repeated pregnancies at short intervals. It may be assumed that
these repeated pregnancies and insufficient nourishment and rest
had rendered the mother peculiarly vulnerable to the germs
of Tuberculosis.
On December 31st the following is a statement of the
particulars appearing in the Register of cases of Tuberculosis.