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With the increase in the number of cases and the improved follow-up visiting of the
homes, together with the additional visiting necessary for the success of the B.C.G. Scheme
which was started, it became evident that to be able to deal adequately with the work of
prevention and after care of tuberculosis patients two additional Tuberculosis Visitors
would be needed. This recommendation was approved by the Health Committee at its meeting
in December.
The very cordial working relations between the Regional Hospital staff on the one
hand and the Local Authority staff on the other continued throughout the year, which
contributed greatly to the good relations between the staff and public.
(b) Work of the Social Worker. Report by Mr.N.E.Forward.
The year has seen a slow and steady development of the Department. Economic
pressures have limited any wide expansion of the service, and the service given has been
done by the Almoner with half-time secretarial assistance.
There has been improved liaison with the Chest Physician, ar.d an extremely close
co-operation with the Tuberculosis Visitors. Indeed, the Almoner's work and that of the
Tuberculosis Visitor is now such close team work that the point at which the Almoner takes
over the social problems from the Tuberculosis Visitor is difficult to determine, though
the main function of each is of course unchanged.
In broad outline, the Tuberculosis Visitors deal not only with the medical aspect,
but advise also on routine social problems where they arise. Moreover, they diagnose and
refer the unusual, larger, or complex social problems to the Almoner. Thus the Almoner
comes to cope with a perhaps smaller case load, but adequate time and attention is available
for those cases needing a detailed social therapy.
Staff limitations has prevented the practice of interviewing all patients attending
the Clinic, and consequently only referred cases have been seen. All notified cases of
tuberculosis are however seen by the Health Visitors and, selection resting mainly with them,
probably very little important social work is overlooked.
There has been little demand from the Chest Physician for detailed social investigation
relating to Individual patients and practically all the work referred has related to helping
patients in particular ways rather than social investigation as a whole.
The attached statistical summary indicates the broad outline of the work.
By reason of a separate allocation to Tuberculous After Care and Prevention of
Illness from the Council's funds, it was possible to satisfy the demand for children's
convalescence this year, which in the preceding year could be met only by a very limited
number of "free" vacancies.
In common with most local authorities, the housing problem continues to be Intense,
it is disappointing that with all the other competing demands in West Ham, it has not proved
possible to give more special consideration to tuberculosis cases, for until this problem
can be tackled In a substantial way, many patients will continue to struggle against their
disease under a severe handicap, and any of the efforts to help them will be frustrated.
The liaison with the Ministry of Labour is good. There is a much better developed
understanding with the D.R.O. at Stratford and the D.R.O. at the Canning Town Employment
Exchange has been most helpful and co-operative.
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