|Article by Sue Comont based on annual reports of the After-Care Committee deposited in the Northamptonshire Record Office|
Rushden TB After-Care Committee
Services to Patients
The most important part of the work of the After-Care Committee was the visiting of TB patients by members of the visiting committee who would talk to the patients and advise them on what help was available for them as well as providing emotional support for patients and their families. The visitors could recommend patients for full or partial grants of food.
A full grant was 7 pints of milk, 10 eggs and 1 pound of butter a week. During its’ first year the committee supplied 661 pounds of butter, 6,600 eggs and 600 gallons of milk in grants. 11 patients received the full grant and 4 had partial grants. Wartime made the continued supply of the grants more difficult: the annual report of 1940 regretted that the rationing of butter and the shortage of eggs had made it impossible to provide full grants as before so the milk allowance had been doubled to 14 pints a week as compensation. Unfortunately, rationing was extended to milk and eggs in 1941 so the distribution of eggs had to stop and a doctor’s certificate was needed to qualify for the 2 pints of milk allowed to TB patients. Matters remained difficult during and immediately after the war, but in 1950 the Committee was able to report that the Ministry of Food now allowed a priority of 14 pints of milk, 3 eggs, 3oz margarine or butter, 1oz bacon and 1oz cooking fats a week to TB sufferers, the latter 3 being in addition to the ordinary ration. The Committee also received gifts of eggs from the Yeldon Sunday School Scholars and honey from the Australian Beekeeper’s Association which were distributed to patients. By 1954 a full grant consisted of 14 pints of milk and 6 eggs each week. The 1955 report explained that help was given not only to patients actively suffering from TB, but also to those who had recovered and who were able to resume their normal occupations until they are financially established again. On average during this year 37 patients had received grants in addition to the help given to the families of patients undergoing treatment in the Sanatorium. The full grant remained at 14 pints of milk and 6 eggs a week until 1971 when rising prices forced the Committee to reduce the amount of milk by half to 7 pints a week which saved 700 gallons in that year.
Monthly grocery vouchers were also granted to sufferers. In 1943 the value of the voucher was raised from 10s a week to 12s 6d and in 1945 it was decided that in very necessitous cases, the value could be raised to £1, with a full grant remaining at 12s 6d and a part grant being worth 7s 6d. In 1953 an average of 43 grants of milk were made each month to patients and their families, and in addition gifts of coal, grocery and clothing were made and sheets and blankets were obtained from a county organisation. The coal allowance was raised in 1962 from 8s to 10s per cwt to meet rising costs. In 1975 the grant was still 7 pints of milk and 6 eggs but the grocery voucher went up to £1 a week to reflect increased prices, rising again in 1977 to £2. It was reported in 1989 that the weekly grants of milk, eggs and grocery vouchers remained fairly constant at 16.
It had been the practice from the early years to give Christmas parcels to patients. The 1933 report expressed gratitude to W.H.Chapman Ltd for supplying boxes and to three local tradesmen for supplying goods at cost price so that parcels could be given to 16 patients. In 1940 it was not possible to make up the usual parcels owing to the shortage of sweets and fruit so 15 vouchers of 5s each were distributed instead. In 1945 it was reported that Christmas gift vouchers were sent to 26 patients, the amount being raised this year to 10s. Most of the vouchers were exchanged for food supplies and the Treasurer drew attention to the economical manner in which they had been used. In one case 16 items of grocery had been purchased. By 1952, 41 Christmas vouchers were distributed. The value of the Christmas voucher had doubled to £2 by 1963, but only 13 were given out in that year. In 1971 the voucher was worth £2 10s, and in 1973 it doubled again and was worth £5. 24 patients received these vouchers in that year. In 1977 the Christmas grant was £15 for each patient.
A new service was begun in 1954 when the committee reported that they had sent 5 patients to a boarding house in Bournemouth for a fortnight which had proved very beneficial in every case. The following year 5 patients were sent to Ramsgate for two weeks under a scheme organised by the National Association for the Prevention of Tuberculosis who had a chain of holiday homes for the purpose. Holidays were continuing in 1963 when 3 patients had recuperative stays at Cliftonville. In 1977 it was reported that a holiday grant of £10 had been given to each patient.
In 1946 the visiting committee began visiting Rushden patients in the Sanatorium who were to receive a gift of 5s a month each. In 1948 this was extended to Rushden patients at Creaton. Sanatorium patients received 10s at Christmas in 1952 and the following year two patients there whose homes were in rural areas where no care committee operated, were adopted by the Executive Committee and were visited and given cash grants. The monthly cash grants were increased to 10s in 1958. In 1967 gifts of sweets, fruit and books were given to children in the hospital who came from areas where there was no care committee.
Extension of Care Work to Rural Areas
In 1945 care work was extended to the rural areas of Wymington and Yeldon. Five TB patients were found in Wymington, one of whom required help and, with the approval of the Bedfordshire Medical Officer of Health, a monthly grant of milk was made. Help was extended to TB patients in Newton Bromswold in 1952.
Help was given in other ways on an individual basis. In 1951 the committee reported that suitable housing for tuberculous persons was an important part of care work and early in the year an approach had been made to the Housing Committee in respect of three patients. Two of them and their families were now settled in council houses and it was hoped that adequate accommodation would be found for the third at an early date. A committee member provided a wireless for another patient in 1953, and in 1954 it was reported that a young patient had received treatment in a Danish Sanatorium and through the generous help of the Industrial Co-op Society, she had been sent away well equipped with clothing. In 1955 A grant of £10 was made towards the provision of a television in the TB ward of St. Mary’s Hospital, Kettering and a self propelled wheel chair for the use of patients at Rushden Sanatorium. Help with travel and rail fares was also provided for families and dependents of patients at other hospitals.
Extension of Care Work to other Chest Diseases
In 1957 the committee agreed that as the incidences of TB were decreasing, and patients were recovering more quickly, care work should be extended to other chest diseases. This resulted in 10 non-TB patients being included in the list of patients visited and given grants. In 1961 the committee reported that the year had seen a changing pattern of care work and the growing importance of helping sufferers from chest complaints other than TB has been acknowledged. There were 6 notifications of TB during the year and 13 of other chest disorders. By 1968 the ratio of new cases had become 7 new TB cases and 39others, which included bronchitis, asthma, lung cancer and other chest complaints. In 1978 there were 3 new TB cases and 151 others, while in 1987 help was extended to provide a monthly grant for a child with cystic fibrosis and a nebuliser for another.
Uncertainty at the San
As the 20th century went on, the future of the Hospital became less certain and established. In 1977 the report referred to concern at the financial cuts proposed by the NHS, which included a reduction in the number of beds, or even the closure of the Rushden Hospital. The Committee associated itself with protests, Mr Graham being appointed to the Committee for the Preservation of Health Services. A house to house canvas was undertaken in certain parts of the town and letters of protest were sent to the Oxford Regional Board, the Northants Area Health Authority and the Kettering Area Health Authority. The committee was relieved to be able to report that “the weight of public opinion has ensured that the closure of the hospital has been avoided.” However, the hospital did not escape unscathed. In 1979 it was reported that Rushden Hospital had been reorganised as a result of plans made in 1977 by the local NHS. Crane Ward became used for skin patients and medical cases were transferred to Hensman and Sharwood wards, meaning a reduction from 38 to 24 beds for chest cases.
In September 1981, the Skin Unit at the Hospital moved to Kettering Hospital and Crane Ward closed with the loss of 14 beds. The number of beds was reduced to 54 from 79 and concern was been expressed to the Area Health Authority. The situation remained uncertain. The report of the following year recalled the considerable changes which had taken place over recent years with the provision of the Skin Unit at the hospital, its use as a day centre, and community beds for the use of local GP’s, but with the closing of the Skin Unit, the handing over of the accommodation to the Social Services and the reduction in beds from 79 to 54, many people remained gravely concerned about the future of the hospital.
The 1983 report described the protest that had been elicited by a proposal to close the hospital. Full closure had been avoided as a result but it was still proposed to close another ward leaving only 20 beds plus a children’s ward, making a total of 33 beds. With the high maintenance cots it was doubtful whether this would be a viable economic unit. The transfer of mentally ill patients from a Northampton Hospital seemed likely. The committee felt that the community beds were very useful to local GP’s and hoped they would be retained as they were also very valuable in giving relatives a rest while patients are in the hospital. There was no doubt, the committee felt, that the after care work must continue, wherever patients are treated.
In November the transfer of elderly, mentally ill and infirm patients began and discussions were begun as to whether the committee would continue with visits. The changeover to full admission of elderly, mentally ill and infirm patients would not take place until later in the year, at which time there would be just 2 chest beds left and 8 for GP patients.
The 1984 report carried a review of the changes at Rushden Hospital which were making the help given by the committee to chest patients more difficult. The Sanatorium had been the premier chest hospital in the county for over 60 years. It had opened as a Sanatorium for patients with pulmonary TB in 1921. Little could be done for patients in the early days but the advent of modern drugs coupled with the work of the Mass Radiography Service, enabled the Hospital to enter its' most successful period from 1950 - 1970 when death from TB practically disappeared and the number of new cases of TB fell dramatically. As a result the hospital was able to provide a comprehensive chest service for all types of chest illness. The next change was the establishment of the Skin Unit in 1958 and in 1967 the Colton Ward was released for mentally subnormal children. As the new extensions at Kettering Hospital were completed, chest patients were admitted there, releasing beds for the local GPs for the care of their own patients. In 1980 Crane Ward was closed for 2 years making the future of the hospital uncertain. It was saved by the decision of the Oxford Regional Health Authority to provide funds for the conversion of the hospital into a unit for the care of elderly, mentally and infirm patients. Sadly this meant that it would no longer be a chest hospital, but meant that its future was reasonably secure. After-Care work remained a necessity, only patients would have been treated at Kettering General Hospital instead of at Rushden. Arrangements had been made for the committee to retrieve the names of any Rushden chest patients requiring help who had been treated at Kettering, and GPs could also refer cases needing help to the After-Care Committee. The personal contact with in-patients would cease but would continue as before to patients when they returned home from hospital.
In 1985 the decision was taken to continue to visit patients at Rushden hospital but to stop the £1 cash gifts.