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Dr. P. E. Baldry, M.B., B.S., M.R.C.P., Ashford Chest Clinic, writes: —
"I don't think I have anything to contribute about the preventive aspects of tuberculosis
as in this well housed area, with good X-ray facilities and prompt chemotherapy
I think everything possible is being done to prevent the spread of this disease.
I have always felt that the most important preventive aspect is early diagnosis and
efficient chemotherapy and I must say that with the wide use of our miniature X-ray
service by general practitioners we are picking up possible cases of tuberculosis promptly.
I have no doubt, too, that the B.C.G. vaccination of school leavers should go on
because it has proved its effectiveness; it is quite unusual these days to see a case of
tuberculosis in "teen-agers" but because there is a small but increasing number of cases
of active tuberculosis now resistant to chemotherapy about, it remains essential to give
teen-agers all possible protection.
I find that the number of active cases of tuberculosis, who have to be confined to
their homes for any appreciable period is becoming extremely small and I think that for
this reason the time is rapidly approaching when there is no place for a Health Visitor
concentrated on tuberculosis alone but that this work could well be done by general
health visitors".
The continued decrease in the number of notified cases of this disease is heartening,
but as pointed out by the Chest Physicians, increased effort is now necessary to search
out and eradicate the remaining sources of infection.
There seems to be a continued trend for the disease to be discovered in the more
elderly population, and with the extension of clinics for the elderly, to other areas of
the Borough, it may be possible to tackle this potential source more effectively.
B.C.G. Vaccination against Tuberculosis
B.C.G. vaccination of schoolchildren at about the age of 13 is carried out under
Section 28 of the National Health Service Act. During 1965, 904 school-children were
skin-tested; of these 735 were found negative and received B.C.G. vaccination. The
details are as follows :—
Skin tested 904
Found positive 131
Found negative 749
Vaccinated 735
After care Facilities
Prior to the re-organisation of London Government and the formation of the new
London Boroughs as from the 1st April, 1965, the responsibility for the provision of
the tuberculosis care and after care services in the Twickenham, Teddington, and
Hampton areas rested with the Middlesex County Council and were undertaken by
medico-social workers of the Hounslow and Ashford Chest Clinics, who also dispensed
extra nourishment grants on behalf of that County. The after care facilities for patients
residing in the Richmond and Barnes area were undertaken by the Barnes and Richmond
Chest and Tuberculosis Care Committee which received grants from the Surrey
County Council towards the costs of the services provided, i.e., extra nourishment
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