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(15) Special difficulties encountered.
Overcrowding, due to the shortage of houses and
poverty, is undoubtedly, a great difficulty. It renders
isolation impossible and increases the risk of infection and
lowers resistance to attack.
Unemployment.—The presence of thousands of unemployed
creates in the employed person a fear of losing his
employment, and compels him to continue at work or to
return to work when he should remain at home. The fact
that so many able-bodied are out of work renders the task
of a tuberculous workman in search of a job almost hopeless.
Advanced cases are met with from time to time. I have
noticed more often that these are uninsured persons working
on their own account in some small business and who postpone
medical treatment until the last possible moment.
During the last five years important changes have taken
place at the Dispensary.
In 1921 the administration of Sanatorium Benefit ceased
to be a function of the Insurance Committee and the Council
became responsible for the provision of Institutional Treatment
and the Tuberculosis Officer became responsible for the
administration of the treatment of domiciliary cases. The
staff of the Dispensary was increased by the addition of two
for the extra clerical work. These two clerks were transferred
from the staff of the Insurance Committee.
In 1922, owing to the increase in the number of cases,
the premises were extended by addition of consulting room
with waiting and dressing rooms. An assistant, Dr. Kilgour,
was appointed.
In 1925 the accommodation at the Dagenham Sanatorium
was increased by the opening of new wards holding 24 beds.
The administration of Institutional Treatment for
children, formerly carried out by the Medical Officer of
Health, was taken over by the Dispensary.
In February, 1925, the present Tuberculosis Officer was
appointed and took up his duties three months later.
P. A. GALPIN,
Tuberculosis Officer.