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46
contended that over 20 per cent. of patients in sanatoria are there
only because there is not suitable accommodation at home for them
to return to. It has been truly stated that the provision of
sanatorium beds is an expensive and unsatisfactory substitute for
unhealthy homes, and that it is not so much more hospital beds that
are wanted as more homes with accommodation to prevent the
exposure of contacts to repeated and massive doses of infection.
HOUSING AND TUBERCULOSIS.
In the light of our knowledge (outlined above) of how the
disease is spread, it is not a matter for surprise that the death rate
from tuberculosis varies inversely with the size of the house, and
that the disease is from three to four times greater in one-roomed
houses than in those with four or more rooms. Evidence of the
correlation between overcrowding and tuberculosis is overwhelming,
and it has been shown that overcrowding is the cause, rather than
the result, of the disease.
Before 1948 the prevention of tuberculosis was regarded as
being of more importance than its cure, but since the advent of the
National Health Service prevention has taken a second place to
treatment. But advances in medical treatment, however spectacular,
can have little effect as long as four out of five infectious
cases are living at home where they can infect their families and
other people.
It is recognised that the home contacts of a person suffering
from tuberculosis are five times more liable to develop the disease
than persons who are not contacts ; and investigations in a London
borough have shown that whereas the spread of tuberculosis to
other members of the family had taken place in one out of every
eight good houses, it had occurred in one out of every five bad
houses.
It is realised that the problems confronting local housing
authorities are many, and that the allocation of tenancies in the
limited number of properties available is a difficult task. Every
applicant for a municipal house naturally presents his claim in as
cogent a manner as possible, and it is no easy task to select the
cases that are most needy.
Collaboration with Housing Authority.
Since 1950 I have had close co-operation with your Council's
Housing Officer in respect of applications for re-housing where