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of living as an aid to recovery and a protection against contracting the disease has
not been conceded.
The Disabled Persons Employment Act (1944) has laid the foundations for the
provision of sheltered employment for the chronic tuberculous patients unfit to
resume their place in normal industry. Little progress has yet been made in developing
the special measures necessary for these patients, but the general provisions of
the Act have been utilised (with the co-operation of the local Rehabilitation Officer)
in securing lighter employment for many patients not so seriously handicapped.
An even more serious problem which, unlike that of rehabilitation, is comparatively
new is the shortage of hospital and sanatorium beds consequent upon the
shortage of nursing and domestic staffs. Before the war, it was possible to get any
patient into hospital or sanatorium without serious delay. Urgent admissions to
hospital could usually be arranged within twenty-four hours, and to sanatorium
within two or three weeks or less. In present circumstances, many dying patients
have to remain at home, often under very unsuitable conditions—crowded homes,
unskilled attention, serious discomfort for themselves and strain for their relatives.
Curable cases needing active treatment to arrest the spread of the disease may
similarly be confined to bed at home for many months before a vacancy can be found
for them and may ultimately be unsuitable for the special treatment which could
have been given earlier. As a result, the duration of their treatment is much prolonged,
the chances of recovery are reduced, and in any case more serious damage is
done before the disease is finally arrested. Apart from the tragedy for the individual,
the economic loss to the nation is considerably increased. With the reduction in the
number of tuberculosis wards available, it is small wonder that many infectious
patients are admitted, through some emergency such as collapse in the street or sudden
severe haemorrhage, to the general wards of hospitals. To meet these problems it is
a matter of extreme urgency that nursing recruitment should be intensified and that
more attractive conditions of pay and service should be offered to recruits.
The other outstanding problem, which is unfortunately not new but has been
aggravated by the war, is that of rehousing the crowded families. The shortage of
hospital and sanatorium accommodation makes this even more urgent than before.
For such new housing as is available, patients with active pulmonary disease are given
preferential consideration by our local housing authorities, but there is inevitably a
long delay.
Some slight alleviation of this problem is secured by the provision of boarding-out
for children belonging to families in which an infectious case is at home. Boarding-out
can also be arranged for children whose mothers have to go away for treatment.
The cost of boarding-out is borne, in approved cases, by the County Council and the
arrangements are made through the Invalid Children's Aid Association. This
Association also arranges convalescence for ailing children not suffering from tuberculosis,
as has our own Borough Council at its Mayfield Home in Sussex.
The difficulty of securing hospital accommodation in the past two years increased
the number of sick patients requiring domiciliary visiting and medical supervision at