|The Rushden Echo and Argus, 6th September, 1940, transcribed by Gill Hollis
County T.B. Conference - After-Care Problems In War Time
Family Income Inquiries Attacked and Defended
“Examine Recruits For T.B. - Extend Cheap Milk Scheme” - Two Resolutions
Family income inquiries in the homes of tuberculous people were warmly defended by County Council doctors after some sharp criticisms had been advanced during a county conference of after-care committees at Rushden on Saturday.
The conference had been called to discuss after-care problems in war-time, and Dr. Harley Williams, senior medical commissioner and secretary-general of the National Association for the Prevention of Tuberculosis, was the leading speaker, Lord Henley presiding over a large company.
Lord Henley said that Rushden people were imbued with the qualities which were the foundation for care and after-care work. One could not do very much in public health without a personal interest in the patients in those who lived around them and in their neighbours.
Lord Henley described the late Dr. J. H. Crane, who was medical superintendent at Rushden House Sanatorium, as “one who was outstanding in these qualities.” Dr. Crane, he said, was a man a dear old friend of many of them who devoted his life to the welfare of the patients in the sanatorium.
He had a personal interest and affection for all those who came in contact with him; he did not regard them as cases they were real live men and women that he was able to encourage, help and give consolation to. He was a warm-hearted, warm-blooded man there was something very human about him, and everyone who came under his care was encouraged to get better.
The chairman suggested that after-care workers who visited people in their homes and saw their difficulties could help the public authorities in the future when they were trying to get improved housing, better food conditions, and all the improvements they were so anxious to get in order to secure an efficient and healthy population.
Having referred to the pre-eminent success of the Rushden Welfare Centre, Lord Henley spoke of the work of the County Council officers of its extent and range. It was a tremendous encouragement to professional workers, he said, to know that the general public were getting to understand their work.
Reviewing the health services of the county, he mentioned that Mr. Frank Sharwood had had a great deal to do with initiating the improvements now nearly completed at Rushden House Sanatorium.
When these were finished they would be able to take in about 70 patients at a time. In 1939, 210 patients were treated there, and that work cost about £10,000.
A great many cases of surgical tuberculosis were treated in the county, and there were some quite marvellous cures of cripples at the Manfield Hospital, where 57 cases were treated, the county spending about £4,000on this service.
Nearly 1,600 patients made nearly 4,000 visits to the dispensaries at Northampton, Kettering and Wellingborough:
The Tuberculosis Officer paid nearly 700 visits to patients in their own houses:
There were 1,100 consultations by the County Tuberculosis Officer with medical men:
The health visitors paid more than 3,500 visits:
X-ray apparatus was now available at all the clinics; and
The County Council spent over £700 a year on extra nourishment and assistance for recommended patients.
It was a very complete service of which they should be proud. The outlook of the care committee should be a very wide one, and it was hoped that in future they would be helpful in every branch of public life. At Rushden very good work had been done.
Good That May Come From War
Dr. Harley Williams said he was last in Rushden about eight years ago and since then he had always associated Dr. Crane with some of the best inspirations in the tuberculosis movement. Dr. Crane was not only a good doctor and a good man, but a man of intense humour, and he managed to lighten the burden of many people by that quality of humour.
People did not think about consumption in the ordinary way, said Dr. Williams; they hoped it would never come to them, and they were rather inclined to let it alone. In fact, it was not entirely different from their attitude a year or two ago towards war. They hoped devoutly it would not come to them, and sometimes they were inclined not to see things which might have been seen; yet when it came to them they accepted it with a courage and knowledge greater than any other nation, he thought, was capable of doing.
The war was teaching us certain things about our social life; it was teaching us that some things were not right in England, and we looked forward to the time when we should be able to go ahead with some of our social work after the war.
In this country, said Dr. Williams, they had had for many years what he had always thought was the ideal method of dealing with the social side of tuberculosis. They had a committee of the County Council to supervise the work generally, and there were care committees about the county which knew the patients and knew their needs and the ways in which some of those needs could be met. Where there was a strong local committee the work would be left to them, and people who knew the tuberculous family would sometimes be able to do more than people living at a distance.
Tuberculosis had got to be tackled from a great variety of points of view. There were some constructive things which did not involve merely giving money into a household for milk and eggs and so forth. There were sometimes other things they could do to set a whole family on its feet, and he hoped they would give particular care to such cases.
Sometimes they could help a family best by not spending their money on the sick person, but by spending it on some other member of the family who was perfectly well, to put him into a better position to earn. This was work that a local committee could do and that an official body could not do.
Tuberculosis was fortunately not a painful disease, but it lasted a long time and people got very tired and fed up, and their spirits might be depressed. When a tuberculous person lost his hope and courage and his way of looking at life in a positive fashion, then he began to go downhill, and all the operations and treatment would be a disappointment unless they helped on his will to recovery. If this was done merely in a routine fashion, then it was something they might just as well leave undone.
Dr. Williams said his own association were trying to foresee what would happen as a result of the war. They hoped there would not be a great rise in the disease, but they did not know.
Speaking of the great importance of early detection, Dr. Williams said that in America, Germany, France and other countries they had developed an idea of examining large numbers of people between 15 and 30, which were the worst times of life for the disease, and in every group they found perhaps one in 100, or more, who had active tuberculosis without noticing it. That was the stage at which people could be treated with a much greater prospect of success and with a shorter course of treatment.
This was one of the things he would like to see arise in Britain after the war. They had not been able to get the Ministry of Labour to do it among recruits, and that was a great opportunity missed.
On this “vexed question” of free and cheap milk Dr. Williams pleaded; “Tuberculosis people are not so many in the country. Their economic position is not good. They could easily be put in.”
Dr. Williams also spoke about the Christmas Seal Campaign, urging committees to take up the idea. The seal, he said, told people that there was such a thing going on against it.
Replying to Mr. F.J. Sharwood, C.C., Dr. Harley Williams said the medical examination of all industrial workers was a thing which was coming he was sure of that.
He did not see why in time everyone should not be examined with tuberculosis in view. Children were examined in school, but he did not think the older children were examined enough, and he hoped the time was coming when large numbers of children were going to be examined with X-rays at the time they were about to leave school.
Young Soldiers Who Have Broken Down
Dr. C. M. Smith, County Medical Officer, said that all recruits to the Australian Expeditionary Force were examined by a new method. Money and time were saved by taking X-ray pictures on a cinematograph film and projecting them on a screen, hundreds of cases being recorded on one film.
Nine thousand men examined by this method had all previously been examined by a medical board and passed as fit in Class I. It was found, however, that one in every 200 was suffering from active signs of pulmonary tuberculosis. The saving which accrued from the detection of those cases far outweighed the initial cost. They had good prospects of initial cures, and they had removed the danger of infection for others.
“I hope,” said Dr. Smith, “that the National Association will shame the Minister of Labour into adopting these new methods for the examination of recruits.
We have had young soldiers in the sanatorium who have been passed for service and have broken down in a comparatively short time.
“It is nobody’s fault. However skilful the doctor may be, he cannot guarantee to detect the presence of tuberculosis by ordinary clinical examination.”
Dr. Smith said he hoped the conference would also deplore the fact that the Minister of Food had had no regard at all for the health aspects of the new milk scheme, in that there was no selection of milk as regards safety. Medical officers had for years been preaching the gospel of safe milk, but now, to a large extent, their good work was being placed in jeopardy.
Forty per cent of the cows in this country reacted to the tuberculin test, and the number of people who died every year in this country as the result of tuberculosis attributable to the bovine tubercle in milk was 2,000 out of full tubercle death total of 40,000.
Dr. Smith said he was hoping that they could do something even yet to advice people that children should never be given milk unless it was tuberculin tested, pasteurised or boiled.
“Means Test Entirely Wrong”
Mr. J. Bettles (Kettering) said his experience as a visitor was that when an application was made to the County Council “they absolutely put the family on the means test before you get anything.” This was wrong entirely. They were not considering the family at all; it was their work to consider the one who was suffering from tuberculosis. Instead of making it a means test for the family they should make it a test only for the one who was ill.
Dr. Harley Williams said he was afraid they could not escape the fact of public assistance whether they liked it or not, though personally he deplored it very much.
Mr. F. E. Ball (Wellingborough) said there were cases when the family did everything they could to help the man, and he did not think they should be asked to do more. It was not a question of how much they had got coming in, but of how little.
“We find,” added Mr. Ball, “that whatever we do, the family will supplement it right up to the hilt. I could give you many cases where the hardship is hellish. It saps the vitality of the mother; if plays the deuce with the father, and so the home is wrecked. When they can’t get help unless the whole of their income is exposed, the family is brought down to the very dregs.”
Dr. G. B. Lord, County Tuberculosis Officer, said it was a fundamental thing in tuberculosis that the whole family must be dealt with as a unit.
“I vehemently deny,” he continued, “that this is a means test in anyway whatever. In a few instances we do write friendly letters with the form asking them to return it to us, but in the great majority of cases I do it myself, or ask visitors to do it for me. I get the information from the patient in a friendly way. I am quite convinced that there is no harshness in the collection of these details from these patients.
“If voluntary care committees wish to apply for relief to a particular patient without reference to the circumstances of the rest of the household, they are entitled to do so.”
Lord Henley said he had never yet known a case in which the committee seemed hard.
Dr. Smith said that there was a world of difference between the rigorous and harsh inquiry which savoured of bumbledom and a sympathetic inquiry as made by Dr. Lord and his health visitors. Dr. Lord was not an administrative officer, and his main interest was in his patients.
He had been Tuberculosis Officer in the county for ten years, and in that time he had never had one complaint from his patients that they resented filling in the form.
“I have been here three years,” added Dr. Smith, “and in that time I have never had a complaint.”
Miss E. Capron, C.C., said she agreed about the importance of having tuberculin tested milk, but the trouble was the expense. If they were going to have it on a large scale then perhaps the Ministry of Health might bring pressure to bear upon the Ministry of Agriculture to assist farmers more than they did.
Dr. Harley Williams said he hoped they were getting towards the day when all cows would be subjected to the test. Admittedly it was expensive, but the Milk Marketing Board, he believed, had given 2d a gallon.
Miss Capon: When you have got it, yes!
Two resolutions were passed. The first, moved by Mr. F.E. Ball, advocated the special examination of all recruits for tuberculosis and of blocks of the public up to the age of 30. The other, moved by Mrs. Martin, Kettering, and seconded by Ald. H. Martin, Kettering, favoured the extension of the free and cheap milk scheme to the tuberculous.
Dr. Harley Williams was thanked by Coun. A. C .A. Colton (Higham Ferrers) and Mr. Sharwood, who is chairman of the Rushden House Sanatorium Committee, Coun. W. E. Capon (Rushden), treasurer of the Rushden After-Care Committee, thanked Lord Henley for presiding.
Counc. and Mrs. Capon afterwards entertained the delegates to tea at the Waverley Hotel and were warmly thanked by several speakers. The visitors went on to the Rushden House Sanatorium and inspected the various departments.
The local arrangements were made by Miss A. M. Sharwood, secretary of the Rushden Tuberculosis After-Care Committee.