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In this connection it is interesting to note that many Authorities
are of the opinion that most of the sanatoria in this country
are too small, and that it would be better in the interests of the
patients to have much larger institutions, with say 250 to 1,000
beds. Such institutions could more easily be provided with
specialists in the different branches of the work and be equipped
to carry out every form of treatment and investigation, and would
possibly be more efficient without increasing expenditure. Such
proposals would necessitate various local Authorities combining.
This method is at present in force in Wales where the treatment
of Tuberculosis for the whole of the Principality is under one
Authority. It, however, causes some dislocation of co-ordination
with the rest of Public Health work and in so doing is disadvantageous.
The Medical Officer of Health and the Tuberculosis Officer
visited the institutions belonging to other authorities in which
Croydon patients were being treated (in addition to weekly visits to
the Borough Sanatorium at Cheam by the Medical Officer of
Health).
In addition, the Tuberculosis Officer paid 45 visits to Mayday
Hospital, in a consultative capacity, and there examined 106
patients.
The Tuberculosis Clinic and Home Visiting.
Table LXIII. gives a summary of the work done in connection
with the Clinic.
466 new cases were examined during the year: this is equal to
253.2 for each 100 deaths from the disease. 197, or 42.3 for each
100 deaths, were found to be definitely tuberculous.
The contacts of definite cases are urged to attend the Clinic
for examination (and subsequent supervision). This is an important
preventive measure. During the year 383 contacts were
examined, equal to 208 for each 100 deaths, compared with 464
in 1932, or 279.5 per 100 deaths. Of these, 14 were considered
to be tuberculous. This is equal to a tuberculosis rate per 1,000
contacts of 36.5, compared with 1.44 per 1,000 of the general
population. In 210 adult contacts examined the tuberculosis rate
per 1,000 contacts was 66.6. Included in the 14 contacts found to
be tuberculous are 4 who had been under observation from previous
years.