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Contacts are examined systematically as far as possible,
more particularly when the nurse is visiting home cases of
tuberculosis. Any contact giving ground for suspicion of early
incidence of tuberculosis is referred for examination to the Dispensary.
There is no doubt, however, that when the suitable
time for extension of the work arrives further medical assistance
will be required to enable the Department to examine and
watch systematically home contact of known cases.
The only special method of examination of cases which has
been employed is examination by X-rays.
The outstanding feature in my opinion of the scheme for
tuberculosis is that without a very complete and effective
system of after-care of tuberculous patients, the effects of
sanatorium and hospital treatment, however good they may be
in themselves, are largely lost. No system of after-care is of
much value unless it has considerable financial backing secured.
No dental treatment is provided by the Local Authority
specifically for tuberculous patients.
One nurse does actual nursing of advanced cases at their
homes.
Approximately forty cases received extra nourishment in
the form of milk regularly.
Cases of non-pulmonary tuberculosis are referred for treatment
to the Royal Sea Bathing Hospital and similar institutions.
Six shelters were provided for the use of patients in their
gardens. These were increased in 1921 by the addition of ten
shelters.
The arrangements for After-care in Croydon were originally
provided for by the establishment of an After-care Committee.
It was, however, found that the Committee as a body
was not really effective on account of the lack of adequate
financial backing. It is an extremely difficult thing to get
voluntary support for this work. The Committee, after a year
or two's existence ceased to exist as such, and the After-care
of tuberculosis patients has developed into individual interest
on the part of the staff of the Public Health Department and
of people who are disposed to give such help and advice.
Patients are advised as to the kind of occupation they
should undertake after return from sanatorium treatment, and
so far as is possible help is given to the patients to obtain such
suitable form of activity. It cannot, however, be too strongly
emphasised, that adequate after-care depends upon assured
financial support.