TUBERCULOSIS IN HOLLAND

Press, Volume XCII, Issue 27751, 31 August 1955, Page 5

TUBERCULOSIS IN HOLLAND

beds now empty in SANATORIA (From a Reuter Correspondent) THE HAGUE. The Dutch fight against tuberculosis has succeeded so well that Holland is now faced with a new problem: what to do with a large number of empty beds.

Many of Holland’s 45 tuberculosis sanatoria may soon be in difficulties, because of lack of patients. Most of these are privately run and. for various reasons, it will be difficult either to adapt them for other purposes or to close them down.

Six years ago, the sanatoria were full and there was a waiting list of 3500 patients trying to gain admission. Today, not only has the waiting list been wiped out. but there are actually 700 empty beds among the 9000 in Dutch sanatoria.

Six years ago, the tuberculosis death rate in the Netherlands was over 24 per 100.000 inhabitants. Today after falling steadily, the figure is 7.5, or less than one third of the 1949 rate.

Dr. C. R. N. F. Van Joost, a medical officer specialising in tuberculosis in the Dutch Government Health Service, believes that this figure is the lowest in the world. He ascribes it chiefly to better feeding and a higher all-round standard of living.

Pasteurisation of milk is another important factor. He believes that these things have had a bigger influence on the incidence of tuberculosis than all the public health measures which have been taken. A Government memorandum. “Empty Sanatorium Beds—An Acute Problem” recalls that as recently as June 1950 an officially-appointed commission proposed to increase the number of beds for the treatment of tuberculosis by 2500. This suggestion was quickly dropped when the mortality rate began to drop so spectacularly. Dr. Van Joost and two other government medical officers were asked to form a new three-man committee to study the changed problem. In its report, the committee forecasts that at the present rate some 750 beds in tuberculosis sanatoria will become vacant every year. This is equivalent to closing down two complete sanatoria each year from now on. The difficulty about closing down whole sanatoria and transferring the remaining patients to another institution is that almost all these sanatoria are private and run on denominational lines. Their boards of governors are bound to strict religious regulations. The tradition of denominational organisation is very deep-seated among the Dutch, and expressed in their politics, their trade unions, their newspapers, their hospitals and even, to some extent, their Protestant and Catholic shops. Moreover, to close down sanatoria would throw people out of work There is plenty of work for nurses and doctors, but it might be difficult to find other jobs for the not inconsiderable number of administrative and house-keeping personnel. Adapting sanatoria for other purSoses, for instance for use as general ospitals. would be difficult and costly, according to Dr. Van Joost. Sanatorium design does not lend itself to conversion to any other use. Two solutions suggested are: that the State should provide help to enable conversion to be carried out: and that foreign patients should be admitted, and their costs paid by their own countries. In the special case of refugees, the Dutch Government, it is argued, would probably be ready to pay, possibly with the help of private Dutch charity. But this second possibility is at present no more than an idea.