View report page

20
The father—not known to be tuberculous—aged 28 years, who is now staying with his
mother-in-law.
It should be noted that another son aged 1¼ years was notified as suffering from tuberculosis
of the lungs on 11-2-38, and died in Paddington Green Hospital on 9-5-38 from toxaemia
due to pulmonary tuberculosis.
This family have no home of their own but live with the wife's parents who occupy 3 rooms
and whose family consists of father, mother, son aged 18 years and male friend aged 54 years. With
them are now staying the son-in-law and the grandson, aged 8 years, above referred to and if their
daughter and their granddaughter are discharged from Clare Hall and Victoria Home, this is the
only place to which they will have to come.
Family M.
This family consists of husband and wife.
The wife is aged 22 years, has been in Clare Hall Sanatorium for the past 10 months and the
Medical Superintendent informs me should go out soon. They have no home of their own but live
with the patient's mother, father, sister and brother, who have 3 bedrooms and 1 small sitting room.
The wife in this case was notified as a case of pulmonary tuberculosis before she was married.
In a letter from the Medical Superintendent of Clare Hall he enquires if anything can be done to
help her in the housing difficulty. You will remember that I did not care to forward the letter to
the Housing Committee without the express direction of the Health Committee in view of the above
circumstances. This express direction the Health Committee did not give.
I think it will be obvious that such families as " S " and " M " above require special housing
provision away from the general community, such as is provided at Village Settlements.
(ii) The second important point is that houses set apart for tuberculous persons on a housing
estate would be regarded by others on the estate as " leper " houses and social difficulties in such
circumstances would not unlikely arise.
Village Settlements.
I have indicated in the early part of the report the purpose of Village Settlements. The
Chief Medical Officer for the Ministry of Health in his Annual Report for 1935 states that " the first
two years after leaving a sanatorium are very critical years. From this it follows that the patient
at first should only work under sheltered circumstances in occupations suitable for his condition.
He must live in as healthy an environment as practicable and his labour may need to be subsidised
in order that he may maintain his dependents and himself. Usually these requirements can only
be entirely satisfied by life in a village settlement."
Again, the Chief Medical Officer in his Annual Report for the year 1937 refers to the fact that
the Sherwood Village Settlement was established by the Nottinghamshire County Council during
the year 1937 adjacent to the Sanatorium Hospital near Mansfield. He goes on to say—"The
importance of the village settlement in a complete scheme for dealing with tuberculosis has frequently
been emphasised in previous annual reports. It is therefore sincerely hoped that the efforts of the
Nottinghamshire Council, the first County Council to undertake the provision of a village settlement,
will prove completely successful."
In a village settlement it is possible for the tuberculous case, if a worker, to be given work
suitable to his condition, whereas employers in the ordinary way cannot cater for a person who is
unable to do the full work.
It should further be observed that in a village settlement a tuberculous patient, even if living
with his family, is under constant supervision and compelled to abide by the rules of the settlement
for his own care and for the prevention of the spread of the disease. Such supervision cannot be
applied in a private dwelling house.
In selecting land for a village settlement for tuberculous cases the County Council can secure
a suitable site where the atmosphere is not deleterious to the patient and where accordingly he can
have the best possible chance. This does not apply to a house, however suitably constructed, in
the more or less built-up areas of the County of Middlesex.
It should also be observed that the economic circumstances of tuberculous families, especially
in cases where the father suffers, are necessarily poor and it is doubtful if such families can live without
special subsidy having regard to the inability of the head of the family to do full-time work or to the
casual nature of his employment.
Having regard to these various circumstances it would appear undesirable to support either
of the Middlesex County Council's proposals, if they do not include a proposal to establish houses
on the lines of a village settlement.
GEORGE F. BUCHAN,
Medical Officer of Health.