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45
allotted a bedroom to himself. While in a few cases what was wanted was
a larger house for the family living in a house too small for them, in the
vast majority of cases where a house was overcrowded there were at least
two families, though often enough these were related. In some cases
the only way to abate the crowding of a house was by the rehousing of a
small family—a family comprising only the man and wife, one of them
being a sufferer. Rehousing such a family conflicted with the Council's
general ruling which had been in force for some time against the allocation
of Council houses to families with no children.
Another difficulty arose in cases in which the sufferer was a member
of the family who were the original tenants of the house, in which case
the most direct way of abating the overcrowding would be by the rehousing
of the sub-tenant family, even though that family did not have a
sufferer. Another difficult class of case is that in which the family needing
to be rehoused is one which, having only recently come to the district, has
no real claims on this district for rehousing. As a corollary to this class
is that of the family which can look only to this district to rehouse them,
but who are living somewhere outside the district. In spite of all these difficulties
it is felt that, in general, the housing of most of those families in
this district in which there is a member suffering from tuberculosis is not
unsatisfactory as assessed by the needs for them to be rehoused on public
health grounds.
The effect of the slowing down of the rate of building construction is
already beginning to be felt, and it might well be that the situation will
become less satisfactory than the state which has been reached. One
effect, at least, must be the deferring of the time when it might be possible,
in determining which families whose claims for rehousing rest on the fact
that a member of that family has open tuberculosis shall be selected for
nomination, for those other factors of the house itself, apart from overcrowding,
such as its general state of maintenance and repair, or the state
of its surroundings, to be given due weight. As long as there is any real
degree of overcrowding it is felt that this factor must outweigh these
others, but it had been hoped that the time was arriving when, the degree
of crowding of the members of the families being only slight, these other
factors could have been given the weight which is their due.
Local sanitary authorities have specific powers and duties in regard
to tuberculosis. The Tuberculosis Regulations authorise a local authority
to supply all such medical or other assistance and all such facilities and
articles as may reasonably be required for the detection of tuberculosis,
for preventing the spread of infection, and for removing conditions
favourable to infection. Amongst the arrangements for the detection of
tuberculosis most local authorities provide for the examination of sputum
for the tubercle bacillus. This work is now carried out at the Colindale
Laboratory as part of the National Laboratory Services. Although the
local authority is concerned with the removal of conditions favourable
to infection, and it is for this reason that it had rehoused so many families
having a family suffering from tuberculosis, in this area the home visiting
is undertaken by the tuberculosis sisters attached to the staff of the local
chest clinic. It is she who advises as to the precautionary measures to be
taken to prevent the spread of infection; from her, reports are received