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76
Night Hostels or Dormitories for the chronic sputum-positive case would be
invaluable. This need is already recognised but far from satisfactorily
implemented.
EMPLOYMENT OF THE QUIESCENT OR ARRESTED TUBERCULOUS PATIENT.
The rehabilitation of the tuberculous patient is intimately linked
with the prevention of relapse and adequate financial provision for him
throughout the whole period of his illness until the day when his rehabilitation
is complete is a matter which constantly brings us to the
difficult problem of the resumption of employment. The patient should,
wherever possible, be encouraged to resume his original occupation,
unless this proves to be unsuitable for hygienic reasons or where the work
is beyond the patient's physical capacity. The Disabled Persons Act, 1944
is to a limited extent helpful in assisting industrial rehabilitation and
vocational training, but in our experience obtaining employment through the
Ministry of Labour Scheme via the Disablement Resettlement Officer is of
limited value. Its effective application is often prejudiced by the lack
of suitable occupations in local industry, by deficiencies in the patient's
education and by long waiting lists for training centres. Facilities for
work under sheltered conditions are, in fact, few and far between. It is
desirable that part-time or modified work for the quiescent case before
resuming full-time employment under industrial conditions should be available.
The well-trained quiescent and arrested case of tuberculosis should not be
considered a "social leper", for the training he has received at a sanatorium
of ten renders him a safer member of the community than an ordinary worker
without this advantage. In this connection a more enlightened view of the
problem by employers and the general public would be of enormous help.
Education of the public by lectures and propaganda should be intensified
and B.B.C. broadcasts on the subject are steps in the right direction.
Colonisation of patients, in many cases with their families, at Enham
Alamein and Papworth Settlements has provided the final stage in the
rehabilitation of many patients. This had proved valuable in selected
cases, but the numbers that can be dealt with in this way are few and there
is a case for extending the s cheme further.
The standard of living of the tuberculous patient. This must be kept
high; priority housing for the tuberculous patients In the Interests of
the community and suitable work in a good environment are all good preventive
measures. The Home Help Service. the service provided by the
District Nurses and the Occupational Therapy service. all provided by the
Council are of enormous value to our patients. We hope that better facilities
for occupational therapy in the home and wider opportunities for
vocational guidance going on to training centres nearer to the patients'
home may be available in the not too distant future.
CO-OPERATION BETWEEN THE CHEST CLINIC AND THE PUBLIC HEALTH DEPARTMENT.
Our constant aim at the Chest Clinic is the closest co-operation
between ourselves and the Public Health Department in the interest of
the prevention of tuberculosis and the care of the tuberculous patient
when at home or at work.
Finally it is our firm conviction that on return from a sanatorium
education,selected patients whose condition is quiescent or arrested can
be reabsorbed into normal Industry and the whole period from diagnosis to
reinstatement into industrial work must be regarded as one continuous
process* To assist the smooth functioning of this process, there must
be the closest co-operation between those concerned with the prevention
and treatment of this disease and in the after-care and rehabilitation of
those afflicted by it. To this end we have afforded every facility for