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9
As an alleviating and social measure, the local authority is
asked to remove from the home all children who may be contacts
of such infected persons, and place them in foster homes or institutions
at a distance, until such time as it is safe to restore them to
their families. Meanwhile, treatment is instituted for the tuberculous
subject in the home, a complete reversal of established
procedure which is basically at fault, for no-one can ensure rigid
isolation and antisepsis under such crowded conditions of living as
exist in the borough, and disruption of home life, especially for the
children should be avoided. There is never the complete assurance
that other children or adults will not visit the infected subject and
receive from him, in a few moments contact, a heavy dose of
virulent tuberculosis germs which may alter, tragically, the whole
tenor of their lives.
It would appear that for a circumscribed county borough,
of a dormitory nature such as East Ham, a strong case could be
made out for the return of its Sanatorium and Isolation Hospital.
Regionalisation can best exert a beneficial action in geographically
large rural and semi-urban populations, where it is manifestly
uneconomic to create numerous small centres for treatment which
are expensive to run and maintain.
In like fashion, the specialist clinics of the local authority
will henceforth be staffed by medical graded personnel from the
Regional Hospital Board. Here also repercussions are to be felt
in that the somewhat onerous terms of engagement asked of the
individuals concerned has resulted in contractions of the services
rendered to the Council.
The " Dental Extraction under Anaesthesia " clinic and the
Ophthalmic clinic have already suffered in this way and it is likely
that the future work of the Child Guidance clinic will be affected
also. It would appear that the problem must be faced, either of
accepting a lower standard of professional service in some of our
clinics, or the Council themselves maintaining the high level
standard over the years by employing and remunerating specialists.
Dual control of such services cannot make for efficiency and
the social aspect of the work generally and the integrity of the
School Health Service in particular, point to the great desirability
of direction and control being vested in the Health Authority
through the Medical Officer of Health.