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32
In addition to administrating the Tuberculosis Regulations of 1925 and 1930
(a duty which remains with the Medical Officer of Health), the Council provided
services at the Dispensaries (a branch dispensary had been opened in Well Hall
Road, Eltham, and later transferred to Carnecke Gardens); by domiciliary visits;
by arrangement with the London County Council, particularly for Institutional
treatment, various hospitals and the Queen's nurses; and by co-operation with
the Maternity and Child Welfare Service, the London County Council School Medical
Services, the Public Assistance Committee, the Ministry of Pensions and the housing
and other authorities.
These services included:—
For the Patients. Investigation for diagnosis by medical examination, X-rays,
and by sputum and tuberculin testing; also by medical consultation with general
practitioners, Hospital doctors, and Ministry of Pension and other officials.
Arrangements for Hospital or Sanatorium treatment; and supervision and assistance
at home during the waiting period. After-care; including arrangements for
nursing ; assistance in the home; supply of garden shelters in suitable cases;
supply of medicaments, surgical appliances, extra nourishment; and when necessary,
by financial assistance. Rehabilitation, including occupational therapy in the form
of handicraft, needlework and cookery classes; arrangements for vocational training,
and assistance in finding suitable re-employment.
For Contacts. An important side of the work has always been the examination
of the contacts of known cases, particularly tuberculin testing and X-ray examination
of child contacts and the making of arrangements for their boarding out in a suitable
environment in order to minimise the risk of infection, or for their admission to
day or boarding open-air schools.
For Doubtful Cases. These are kept under observation and examined at
intervals in order that disease may be detected and treated in its early stages.
In all this work, the help of the Care Committee with its funds collected by local
voluntary effort, has proved invaluable, particularly in solving personal problems
coming outside the scope of official regulations.
A review of the changing aspects of the work since 1911, or since 1921 when
the Council became responsible, mirrors the changes on the social services, in the
public recognition of the problem involved, and in medical advancement of knowledge.
Early diagnosis is facilitated by the wide use of X-rays including Mass
radiography surveys, and by a growing public consciousness of its need. Treatment
in addition to rest, good food and fresh air, is now supplemented by many other
procedures such as artificial pneumothorax, phrenic crush, pneumo-peritoneum,
thoracoplasty, and operative removal of the whole or part of a lung. Also newly
discovered drugs are a further aid to recovery, and B.C.G. vaccination offers hope
for the future.
The tuberculosis and family allowances and additional nourishment, ease the
psychological strain of illness. Schemes for vocational training together with the
Ministry of Labour, Disabled Persons Register, help with the all important problem
of rehabilitation. And finally, the Home Help scheme gives the harassed housewife
a chance.
Thus, as is reflected in the lower death rate, many of the problems confronting
the pioneers in 1911 have been partly solved, but others such as the housing shortage
remain as a challenge to the future.