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receiving Domiciliary treatment until arrangements could be made for their treat
ment at a Sanatorium; 9 were recommended to be admitted as in-patients of
Hospitals, 5 being admitted before the end of the year. The total number of Stepney
residents admitted to Sanatoria up to date is 35. I understand these arrangements
were only meant to be of a temporary nature. They were certainly unsatisfactory,
and it is hoped that the permanent arrangements will be of a more efficient character.
The fact that nearly 90 per cent. of the insured persons, who were considered to
be consumptive by their own medical attendant did not apply for Sanatorium
benefits is unsatisfactory. It must be remembered that unless they applied and
were examined by the Insurance Committee's Medical Referee, the doctors did
not receive payment for the Domiciliary treatment agreed to by that Committee.
The Dispensaries suffered a similar loss. (The financial arrangements for the
Domiciliary treatment of consumptives by medical men have since been altered).
The objections given by the insured persons were in my opinion reasonable:—
(1) They would lose a day's work to go to the West End to be examined, as no
arrangements were made for an evening examination. (2) They were obliged to
produce their Insurance Card. In a large number of instances these cards were
kept by the employer. If an insured person made an application for the card,
suspicion was aroused. If the reason for the application was given, the insured
person might be dismissed, as some employers object to a consumptive patient
as an employee. If the reason be withheld, the employee might be suspected, and the
employer may have the impression that another situation is looked for. In any
case the result is equally unpleasant and occasionally disastrous to the employee.
(3) The insured person was too ill to leave his bed or his room.
These objections were brought to the notice of the London Insurance Committee
by the Stepney Sanatorium Sub-Committee, and with respect to the last
objection, the Committee waived the necessary examination by their Medical
Referee on the patient producing a medical certificate that he was too ill to attend.
These objections can be obviated by the appointment of a Tuberculosis Officer
in each Metropolitan Borough, and as medical benefits have come into operation,
the red ticket for medical attendance may be utilised. The production of this
ticket may be made a sufficient guarantee of the identity of the patient.
Scheme for the Treatment of Tuberculosis.
A comprehensive scheme for the treatment of Tuberculosis should consist of
two parts
(1) Institutional treatment.
(2) Non-institutional treatment.
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