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Page 31
centre. Such a centre would be of value both physically and psychologically
to those patients who were convalescent but not yet fit
to go back to work.
In most cases there is next a phase when the patient is fit to
resume part-time work for a few hours per day. In practice it is
exceptionally difficult to arrange this, since firms (and, I am sorry to
say, even some public bodies) are often unwilling to allow employees
to resume part-time work. There are also difficulties from the point
of view of the National Insurance Regulations, which only recognize
an individual as being 100% ill or 100% fit.
The permanent employment of those who are unlikely to be able
to go back to their former jobs, and those who are likely to remain
infectious, urgently calls for solution. During the year a series of
meetings was held on the initiative of our neighbours in East Ham.
These were ended by the Chest Physicians and Medical Officers of
Health from East and West Ham, Ilford, Barking and Dagenham and
by a representative from the Ministry of Labour. As a result of our
discussions was decided to ask the Ministry to consider setting up
a special workshop for the tuberculous to cover this part of Greater
London.
Although this particular suggestion has not been adopted it is
possible that an alternative scheme, using the care and after care
provisions of the National Health Service Act, may yet emerge as a
result of our liberations and certain other parallel suggestions put
forward by the Barking Association for the Welfare of the Physically
Handicapped
home conditions
The Ministry memorandum stated: "It is essential that the Medical
Officer of Health and his staff shall have detailed knowledge of the
home condition of all persons suffering from tuberculosis in his area.
Without such information he cannot properly advise his Council on
housing requirements."
It so happened that I was making such a survey when the
memorandum was received, concentrating first on those families where,
in the opinion of the Tuberculosis Health Visitors, conditions were
worst. This initial survey covered 44 households and an attempt was
made to assess in each case the risk of further spread of infection under
existing conditions.