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The ratio of non-notified tuberculosis deaths to total tuberculosis deaths was 1 : 12.
When a death from tuberculosis is registered and no record of notification is found, a letter
is sent to the medical practitioner certifying the death, asking for his reasons, and the answers have
in all cases proved satisfactory—the medical practitioner having believed that the case had previously
been notified.
The Public Health (Tuberculosis) Regulations, 1930, came into operation on January 1st,
1931. They place clearly upon the District Medical Officer of Health the duty to take such steps
as are necessary or desirable for investigating the source of infection, for preventing the spread of
infection and for removing conditions favourable to infection.
Since the beginning of the year the Council's Health Visitor has visited cases of Tuberculosis.
She has investigated the source of infection and given advice for preventing the spread of infection.
She is able to arrange for the provision of paper handkerchiefs and sputum bottles with disinfectant.
She is also able to arrange for the loan of bed and bedding to enable the patient to sleep in a separate
bed, but in most cases the patients are not able to avail themselves of the offer because there is no
space in the home in which to fit it in. Ring pillows have been provided in emaciated cases with a
view to the prevention of bed sores. Contacts are advised to attend at the Tuberculosis Dispensary
of the Middlesex County Council for examination.
Many of the patients appear to need medical and nursing care in their homes whilst waiting
admission to a sanatorium or when ill at home.
On page 51 of the Middlesex County Council 1928 Annual Report is set out the Middlesex
County Council Scheme for home nursing of cases of tuberculosis. On page 50 of the 1929 Report,
paragraph (iii.), appears the remark: "there was very little call upon the service provided, possibly
because its existence was not fully appreciated by all the various nursing associations functioning in
the County, and possibly also on account of the very necessary restrictions imposed by the County
Council with regard to the type of case suitable to be dealt with by a service of this nature."
The treatment of patients and the supply of dressings, where necessary, do not appear to be
undertaken by the Middlesex County Council at their Tuberculosis Dispensary.
Delicate or debilitated children who are receiving treatment at the Health Centres of the
Willesden Council, or who are under consideration for a stay in a Convalescent Home under the
Willesden Council's Scheme, cease to have these benefits if they become notified cases of Tuberculosis.
The housing conditions of the majority of tuberculosis families are unsuitable, and make
measures for the care of the patient and the prevention of spread of the disease difficult, if not indeed,
impossible.